{"id":10152,"date":"2026-04-02T19:34:35","date_gmt":"2026-04-02T19:34:35","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10152"},"modified":"2026-04-02T19:34:36","modified_gmt":"2026-04-02T19:34:36","slug":"trace-5-4-extrasystoles-atriales-avec-aberration-de-conduction","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-5-4-extrasystoles-atriales-avec-aberration-de-conduction\/","title":{"rendered":"Trac\u00e9 5.4: Extrasystoles atriales avec aberration de conduction"},"content":{"rendered":"","protected":false},"featured_media":10151,"template":"","ecg_case_type":[254],"language_ecgcase":[259],"class_list":["post-10152","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-extrasystoles","language_ecgcase-french"],"acf":{"ecg_case_title":"Trac\u00e9 5.4: Extrasystoles atriales avec aberration de conduction","patient_description":"M\u00eame patient que le trac\u00e9 pr\u00e9c\u00e9dent: homme de 75 ans pr\u00e9sentant une FA paroxystique; adress\u00e9 pour diagnostic de bradycardie (prise de pouls par son m\u00e9decin traitant) et dis\u00ad cussion pour implantation d\u2019un stimulateur cardiaque","quiz_question":"Sur cet ECG, on retrouve:","quiz_answer_1":"une dysfonction sinusale","quiz_answer_2":"des extrasystoles atriales bloqu\u00e9es","quiz_answer_3":"une extrasystole ventriculaire","quiz_answer_4":"une extrasystole atriale suivie d\u2019un QRS avec bloc de branche gauche","quiz_answer_5":"une extrasystole atriale suivie d\u2019un QRS avec bloc de branche droit","correct_answer":["B","D"],"ecg_image":10151,"ecg_description":"L\u2019aspect de l\u2019ECG est pratiquement identique \u00e0 celui du trac\u00e9 pr\u00e9c\u00e9dent avec des extrasystoles atriales bloqu\u00e9es et un trig\u00e9minisme; on retrouve au d\u00e9but du trac\u00e9 une extrasystole atriale suivie d\u2019un QRS large (aberration de conduction type bloc de branche gauche); ","ecg_info_box":"Une aberration de conduction suivant une extrasystole atriale a d\u2019autant plus de chance de se produire que l\u2019extrasystole est tr\u00e8s pr\u00e9coce et que le cycle qui pr\u00e9c\u00e8de est plus long ce qui entraine un allongement de la p\u00e9riode r\u00e9fractaire de la branche bloqu\u00e9e. Sur un m\u00eame trac\u00e9, diff\u00e9rents niveaux d\u2019aberration (bloc complet, incomplet ou fasciculaire) peuvent \u00eatre observ\u00e9s en fonction du degr\u00e9 de pr\u00e9maturit\u00e9.","commentary_ecg":"Une extrasystole avec QRS fin permet quasiment d\u2019\u00e9liminer le diagnostic d\u2019extrasystole ventriculaire (certaines extrasystoles ventriculaires provenant du septum peuvent avoir un QRS < 120 ms). En revanche, quand le QRS est large, les 3 hypoth\u00e8ses restent possibles (extrasystole ventriculaire, extrasystole atriale ou jonctionnelle avec bloc de branche complet permanent ou fonctionnel). Les p\u00e9riodes r\u00e9fractaires des 2 branches peuvent \u00eatre diff\u00e9rentes expliquant qu\u2019un influx pr\u00e9matur\u00e9 peut rencontrer une seule des 2 branches en p\u00e9riode r\u00e9fractaire (bloc de branche gauche ou droit). Le bloc de branche peut \u00eatre complet (comme sur ce trac\u00e9), incomplet ou fasciculaire (bloc localis\u00e9 au niveau de la conduction distale). Quand le bloc de branche survient sur un complexe pr\u00e9matur\u00e9 (une extrasystole par exemple comme sur ce trac\u00e9), on parle de bloc en phase 3 ou ph\u00e9nom\u00e8ne d\u2019Ashman. A la suite d\u2019une extrasystole atriale, un bloc de branche droit fonctionnel est plus fr\u00e9quent qu\u2019un bloc de branche gauche, la p\u00e9riode r\u00e9fractaire de la branche droite \u00e9tant habituellement plus longue. Cela n\u2019est pas une r\u00e8gle absolue comme d\u00e9montr\u00e9 sur ce trac\u00e9. A l\u2019oppos\u00e9 quand le bloc survient \u00e0 la suite d\u2019un ralentissement de fr\u00e9quence, on parle de bloc en phase 4; le bloc de branche gauche est alors plus fr\u00e9quent.","ecg_info_post_answer":"\"\""},"yoast_head":"\nTrac\u00e9 5.4: Extrasystoles atriales avec aberration de conduction - Cardiocases<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-5-4-extrasystoles-atriales-avec-aberration-de-conduction\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 5.4: Extrasystoles atriales avec aberration de conduction - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-5-4-extrasystoles-atriales-avec-aberration-de-conduction\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-02T19:34:36+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-5-4-extrasystoles-atriales-avec-aberration-de-conduction\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-5-4-extrasystoles-atriales-avec-aberration-de-conduction\/\",\"name\":\"Trac\u00e9 5.4: Extrasystoles atriales avec aberration de conduction - 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