{"id":10199,"date":"2026-04-03T13:28:08","date_gmt":"2026-04-03T13:28:08","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10199"},"modified":"2026-04-09T10:10:44","modified_gmt":"2026-04-09T10:10:44","slug":"trace-7-2-aspect-intermittent-de-pre-excitation-ventriculaire","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-2-aspect-intermittent-de-pre-excitation-ventriculaire\/","title":{"rendered":"Trac\u00e9 7.2: Aspect intermittent de pr\u00e9-excitation ventriculaire"},"content":{"rendered":"","protected":false},"featured_media":10198,"template":"","ecg_case_type":[256],"language_ecgcase":[259],"class_list":["post-10199","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-junctional-tachycardia","language_ecgcase-french"],"acf":{"ecg_case_title":"Trac\u00e9 7.2: Aspect intermittent de pr\u00e9-excitation ventriculaire","patient_description":"Jeune fille de 15 ans hospitalis\u00e9e pour bilan de palpitations","quiz_question":"Concernant cet ECG, quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s)?","quiz_answer_1":"bloc de branche gauche fr\u00e9quence-d\u00e9pendant","quiz_answer_2":"syndrome coronarien aigu","quiz_answer_3":"bloc de branche droit intermittent","quiz_answer_4":"pr\u00e9-excitation ventriculaire intermittente","quiz_answer_5":"syndrome de Brugada","correct_answer":["D"],"ecg_image":10198,"ecg_description":"Dans la partie initiale du trac\u00e9, on retrouve un rythme sinusal avec un espace PR normal, un QRS fin (pr\u00e9sence d\u2019une onde q septale en V6) et des troubles de la repolarisation asp\u00e9cifiques; \u00e0 la faveur d\u2019un l\u00e9ger ralentissement de la fr\u00e9quence cardiaque, apparition d\u2019une pr\u00e9-excitation ventriculaire avec PR court, onde delta et troubles de la repolarisation; le sous-d\u00e9calage du segment ST et l\u2019inversion de l\u2019onde T quasi-syst\u00e9matique dans toutes les d\u00e9rivations par rapport au trac\u00e9 initial peuvent \u00eatre imput\u00e9s \u00e0 la modification d\u2019activation et \u00e0 l\u2019apparition de la pr\u00e9-excitation;","ecg_info_box":"La conduction dans un faisceau de Kent se fait selon la loi du tout ou rien. La dangerosit\u00e9 de ce type de voie accessoire r\u00e9side dans l\u2019existence d\u2019une p\u00e9riode r\u00e9fractaire courte. Un aspect intermittent en rythme sinusal (apparition lors d\u2019une bradycardie) est en faveur d\u2019une p\u00e9riode r\u00e9fractaire longue et d\u2019un caract\u00e8re b\u00e9nin.","commentary_ecg":"Cette jeune patiente pr\u00e9sentait donc une voie accessoire \u00e0 conduction ant\u00e9rograde intermittente. La conduction dans une voie accessoire r\u00e9pond \u00e0 la loi du tout ou rien: le faisceau est ou n\u2019est pas en p\u00e9riode r\u00e9fractaire et l\u2019influx est transmis ou n\u2019est pas transmis aux ventricules. La p\u00e9riode r\u00e9fractaire ant\u00e9rograde de cette voie est longue, un ralentissement de l\u2019activit\u00e9 sinusale est n\u00e9cessaire pour que la pr\u00e9-excitation devienne visible. Pour une fr\u00e9quence sup\u00e9rieure, l\u2019\u00e9lectrocardiogramme est donc normal (bloc en phase 3).\r\n\r\nCe type de voie accessoire est consid\u00e9r\u00e9 comme b\u00e9nin dans la mesure o\u00f9 une p\u00e9riode r\u00e9fractaire longue prot\u00e8ge le patient du risque de mort subite secondaire \u00e0 une fibrillation auriculaire rapide conduite par la voie. En revanche, cet aspect particulier ne pr\u00e9sage en rien de la p\u00e9riode r\u00e9fractaire r\u00e9trograde de la voie et cette patiente pr\u00e9sentait des tachycardies orthodromiques par r\u00e9entr\u00e9e (bonne conduction r\u00e9trograde) avec une symptomatologie invalidante. Devant la fr\u00e9quence des crises (tachycardies quotidiennes), elle a b\u00e9n\u00e9fici\u00e9 de l\u2019ablation d\u2019une voie ant\u00e9ro-septale.","ecg_info_post_answer":"\"\"\"\"\r\n\r\n "},"yoast_head":"\nTrac\u00e9 7.2: Aspect intermittent de pr\u00e9-excitation ventriculaire - 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-7-2-aspect-intermittent-de-pre-excitation-ventriculaire\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 7.2: Aspect intermittent de pr\u00e9-excitation ventriculaire - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-2-aspect-intermittent-de-pre-excitation-ventriculaire\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-09T10:10:44+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-2-ecg-4-scaled-e1775222805602.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2330\" \/>\n\t<meta property=\"og:image:height\" content=\"1360\" \/>\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-7-2-aspect-intermittent-de-pre-excitation-ventriculaire\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-7-2-aspect-intermittent-de-pre-excitation-ventriculaire\/\",\"name\":\"Trac\u00e9 7.2: Aspect intermittent de pr\u00e9-excitation ventriculaire - 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