{"id":10177,"date":"2026-04-02T20:21:15","date_gmt":"2026-04-02T20:21:15","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&#038;p=10177"},"modified":"2026-04-09T09:58:53","modified_gmt":"2026-04-09T09:58:53","slug":"trace-6-6-flutter-horaire","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-6-6-flutter-horaire\/","title":{"rendered":"Trac\u00e9 6.6: Flutter horaire"},"content":{"rendered":"","protected":false},"featured_media":10176,"template":"","ecg_case_type":[255],"language_ecgcase":[259],"class_list":["post-10177","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-atrial-fibrillation-atrial-flutter-atrial-tachycardia","language_ecgcase-french"],"acf":{"ecg_case_title":"Trac\u00e9 6.6: Flutter horaire","patient_description":"Homme de 78 ans avec ant\u00e9c\u00e9dents d\u2019embolie pulmonaire et c\u0153ur pulmonaire chro\u00ad nique; hospitalisation pour palpitations (fr\u00e9quence \u00e0 130 bpm); enregistrement de l\u2019\u00e9lectrocardiogramme au moment de la r\u00e9alisation d\u2019un massage sino-carotidien","quiz_question":"Quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s) concernant le(s) diagnostic(s) sur cet ECG?","quiz_answer_1":"bloc de branche gauche","quiz_answer_2":"bloc de branche droit + h\u00e9mibloc ant\u00e9rieur gauche","quiz_answer_3":"bloc de branche droit + h\u00e9mibloc post\u00e9rieur gauche","quiz_answer_4":"tachycardie ventriculaire","quiz_answer_5":"flutter atrial","correct_answer":["B","E"],"ecg_image":10176,"ecg_description":"Tachycardie \u00e0 130 bpm avec QRS large, retard droit, axe gauche; le massage carotidien ralentit la conduction nodale et permet de mettre en \u00e9vidence une activit\u00e9 atriale rapide, r\u00e9guli\u00e8re et monomorphe \u00e0 260 bpm; la morphologie ne correspond pas \u00e0 celle d\u2019un flutter commun antihoraire; l\u2019onde de d\u00e9polarisation atriale est positive, large dans les d\u00e9rivations inf\u00e9rieures avec une encoche visible en DII, DIII mais \u00e9galement en aVR; l\u2019activit\u00e9 atriale est n\u00e9gative en V1 et positive en V6; il s\u2019agit donc d\u2019un flutter atrial horaire de l\u2019oreillette droite avec initialement une conduction en 2\/1 avec un bloc de branche droit et un h\u00e9mibloc ant\u00e9rieur gauche;","ecg_info_box":"L\u2019aspect de flutter atrial horaire droit inclut: 1) une fr\u00e9quence atriale habituellement comprise entre 250 et 300 bpm, 2) une activation atriale positive avec une encoche dans les d\u00e9rivations inf\u00e9rieures, 3) un aspect peu volt\u00e9 en aVL, 4) une composante positive en V6 et n\u00e9gative en V1","commentary_ecg":"10% des patients pr\u00e9sentant des \u00e9pisodes de flutter commun pr\u00e9sentent \u00e9galement des \u00e9pisodes de flutter horaire, le circuit de r\u00e9entr\u00e9e atriale droite \u00e9tant le m\u00eame mais tournant dans l\u2019autre sens (sens des aiguilles d\u2019une montre). Les contraintes anatomiques et fonctionnelles sont identiques au flutter commun mais l\u2019activation est invers\u00e9e, cranio-caudale au niveau du septum, caudo-c\u00e9phalique au niveau du mur ant\u00e9rieur. Si l\u2019incidence de ce type de flutter est relativement faible, il est en revanche possible de l\u2019induire par stimulation en salle d\u2019\u00e9lectrophysiologie chez 50% des patients pr\u00e9sentant un flutter commun.\r\n\r\nSur l\u2019\u00e9lectrocardiogramme, on retrouve un aspect monomorphe et rapide (cycle de la tachycardie identique \u00e0 celui du flutter commun) de l\u2019activit\u00e9 atriale. Certains \u00e9l\u00e9ments caract\u00e9ristiques permettent de faire le diagnostic: \r\n\u2022 Dans les d\u00e9rivations inf\u00e9rieures DII, DIII, aVF: on retrouve fr\u00e9quemment une onde principalement positive, large avec une encoche de la partie positive en DII (aspect de flutter positif en inf\u00e9rieur); l\u2019aspect peut-\u00eatre moins caract\u00e9ristique avec une activit\u00e9 atriale n\u00e9gative rappelant l\u2019aspect du flutter commun \r\n\u2022 L\u2019onde de d\u00e9polarisation atriale est souvent n\u00e9gative et peu volt\u00e9e avec une encoche en aVL \r\n\u2022 La d\u00e9rivation V1 pr\u00e9sente souvent \u00e9galement un aspect caract\u00e9ristique, avec une activation bifide n\u00e9gative large; une encoche peut \u00eatre \u00e9galement mise en \u00e9vidence au milieu de la n\u00e9gativit\u00e9 de l\u2019onde de flutter\r\n\u2022 On retrouve une transition dans le pr\u00e9cordium entre l\u2019activit\u00e9 n\u00e9gative en V1 et l\u2019activit\u00e9 positive en V6","ecg_info_post_answer":"<img class=\"alignnone wp-image-10330 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/page-273-1024x597.png\" alt=\"\" width=\"800\" height=\"466\" \/>"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Trac\u00e9 6.6: Flutter horaire - 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-6-6-flutter-horaire\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 6.6: Flutter horaire - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-6-6-flutter-horaire\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-09T09:58:53+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-6-6-ecg-2.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"1750\" \/>\n\t<meta property=\"og:image:height\" content=\"1275\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/\",\"name\":\"Trac\u00e9 6.6: Flutter horaire - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\/\/cardiocases.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-6-6-ecg-2.jpeg\",\"datePublished\":\"2026-04-02T20:21:15+00:00\",\"dateModified\":\"2026-04-09T09:58:53+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#primaryimage\",\"url\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-6-6-ecg-2.jpeg\",\"contentUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-6-6-ecg-2.jpeg\",\"width\":1750,\"height\":1275},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/cardiocases.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trac\u00e9 6.6: Flutter horaire\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/cardiocases.com\/#website\",\"url\":\"https:\/\/cardiocases.com\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker &amp; ICD learning \u2014 built by electrophysiologists\",\"publisher\":{\"@id\":\"https:\/\/cardiocases.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/cardiocases.com\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/cardiocases.com\/#organization\",\"name\":\"Cardiocases\",\"url\":\"https:\/\/cardiocases.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png\",\"contentUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png\",\"width\":1755,\"height\":499,\"caption\":\"Cardiocases\"},\"image\":{\"@id\":\"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.linkedin.com\/company\/cardiocases\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Trac\u00e9 6.6: Flutter horaire - Cardiocases","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-6-6-flutter-horaire\/","og_locale":"fr_FR","og_type":"article","og_title":"Trac\u00e9 6.6: Flutter horaire - Cardiocases","og_url":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-6-6-flutter-horaire\/","og_site_name":"Cardiocases","article_modified_time":"2026-04-09T09:58:53+00:00","og_image":[{"width":1750,"height":1275,"url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-6-6-ecg-2.jpeg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Dur\u00e9e de lecture estim\u00e9e":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/","url":"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/","name":"Trac\u00e9 6.6: Flutter horaire - Cardiocases","isPartOf":{"@id":"https:\/\/cardiocases.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#primaryimage"},"image":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#primaryimage"},"thumbnailUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-6-6-ecg-2.jpeg","datePublished":"2026-04-02T20:21:15+00:00","dateModified":"2026-04-09T09:58:53+00:00","breadcrumb":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#primaryimage","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-6-6-ecg-2.jpeg","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-6-6-ecg-2.jpeg","width":1750,"height":1275},{"@type":"BreadcrumbList","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-6-6-flutter-horaire\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/cardiocases.com\/"},{"@type":"ListItem","position":2,"name":"Trac\u00e9 6.6: Flutter horaire"}]},{"@type":"WebSite","@id":"https:\/\/cardiocases.com\/#website","url":"https:\/\/cardiocases.com\/","name":"Cardiocases","description":"Real cardiac device traces, pacemaker &amp; ICD learning \u2014 built by electrophysiologists","publisher":{"@id":"https:\/\/cardiocases.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/cardiocases.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/cardiocases.com\/#organization","name":"Cardiocases","url":"https:\/\/cardiocases.com\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","width":1755,"height":499,"caption":"Cardiocases"},"image":{"@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.linkedin.com\/company\/cardiocases\/"]}]}},"_links":{"self":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case\/10177","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case"}],"about":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/types\/ecg_case"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media\/10176"}],"wp:attachment":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media?parent=10177"}],"wp:term":[{"taxonomy":"ecg_case_type","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case_type?post=10177"},{"taxonomy":"language_ecgcase","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/language_ecgcase?post=10177"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}