{"id":10227,"date":"2026-04-03T14:23:21","date_gmt":"2026-04-03T14:23:21","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&#038;p=10227"},"modified":"2026-04-03T14:23:21","modified_gmt":"2026-04-03T14:23:21","slug":"trace-7-13-maladie-debstein-avec-pre-excitation","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-13-maladie-debstein-avec-pre-excitation\/","title":{"rendered":"Trac\u00e9 7.13: Maladie d\u2019ebstein avec pr\u00e9-excitation"},"content":{"rendered":"","protected":false},"featured_media":10226,"template":"","ecg_case_type":[256],"language_ecgcase":[259],"class_list":["post-10227","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 7.13: Maladie d\u2019ebstein avec pr\u00e9-excitation","patient_description":"Jeune fille de 11 ans pr\u00e9sentant une maladie d\u2019Ebstein et une voie accessoire ; stable sur le plan cardiovasculaire avec quelques \u00e9pisodes de palpitations paroxystiques","quiz_question":"Quel(s) est(sont) le(s) diagnostic(s) possible(s) sur cet ECG?","quiz_answer_1":"bloc de branche droit","quiz_answer_2":"voie accessoire","quiz_answer_3":"s\u00e9quelle de n\u00e9crose post\u00e9rieure","quiz_answer_4":"s\u00e9quelle de n\u00e9crose ant\u00e9rieure","quiz_answer_5":"bloc de branche gauche","correct_answer":["B"],"ecg_image":10226,"ecg_description":"Rythme sinusal; aspect de pr\u00e9-excitation avec espace PR tr\u00e8s court, onde delta; d\u00e9viation axiale gauche du QRS; aspect Qs en V1, QR en V2; probable voie accessoire post\u00e9ro-septale droite","ecg_info_box":"La maladie d\u2019Ebstein est la cardiopathie cong\u00e9nitale o\u00f9 l\u2019observation d\u2019une voie accessoire est la plus fr\u00e9quente. La pr\u00e9-excitation supprime l\u2019aspect typique de bloc de branche droit. L\u2019espace PR est g\u00e9n\u00e9ralement plus long que pour une voie accessoire traditionnelle et le complexe QRS est souvent peu pr\u00e9-excit\u00e9.","commentary_ecg":"La maladie d\u2019Ebstein est classiquement caract\u00e9ris\u00e9e par un d\u00e9veloppement anormal de la valve tricuspide, le feuillet septal \u00e9tant d\u00e9plac\u00e9 dans le ventricule droit. Une correction chirurgicale est souvent n\u00e9cessaire devant une fuite valvulaire importante, une cyanose associ\u00e9e par shunt inter atrial et\/ou devant d\u2019autres anomalies anatomiques associ\u00e9es. A l\u2019adolescence et \u00e0 l\u2019\u00e2ge adulte, l\u2019\u00e9volution est marqu\u00e9e par la survenue fr\u00e9quente d\u2019\u00e9pisodes d\u2019arythmie.\r\n\r\nLa maladie d\u2019Ebstein est la cardiopathie cong\u00e9nitale o\u00f9 l\u2019observation d\u2019une voie accessoire est la plus fr\u00e9quente puisqu\u2019estim\u00e9e entre 10 et 40% (versus moins de 0.1% dans la population g\u00e9n\u00e9rale). L\u2019immense majorit\u00e9 de ces voies accessoires sont situ\u00e9es \u00e0 droite et principalement au niveau de la partie post\u00e9ro-septale ou post\u00e9ro-lat\u00e9rale de l\u2019anneau tricuspidien. Le diagnostic est parfois difficile \u00e0 faire sur l\u2019\u00e9lectrocardiogramme. En effet, un retard de conduction intra-atrial majeur est fr\u00e9quent entrainant un temps allong\u00e9 entre n\u0153ud sinusal et partie auriculaire de la voie accessoire. Ces voies accessoires sont souvent longues et pr\u00e9sentent des vitesses de conduction lentes. Il en r\u00e9sulte un PR plus long que pour une voie accessoire traditionnelle et un complexe QRS peu pr\u00e9-excit\u00e9. Ce n\u2019est pas le cas chez cette patiente o\u00f9 l\u2019espace PR est tr\u00e8s court et la pr\u00e9-excitation facilement visualisable. De surcroit, un nombre important de patients pr\u00e9sentent plusieurs voies accessoires rendant la localisation sur l\u2019\u00e9lectrocardiogramme difficile. \r\n\r\nIl est possible comme chez ce patient de mettre en \u00e9vidence certaines caract\u00e9ristiques \u00e9lectrocardiographiques. La pr\u00e9-excitation supprime l\u2019aspect typique de bloc de branche droit observ\u00e9 dans ce type de cardiopathie, avec en g\u00e9n\u00e9ral d\u00e9viation axiale gauche du QRS dans le plan frontal et morphologie QS ou rS en V1. L\u2019absence d\u2019un bloc de branche droit sur l\u2019\u00e9lectrocardiogramme de surface doit donc sugg\u00e9rer la pr\u00e9sence d\u2019une voie accessoire. De m\u00eame, la r\u00e9apparition d\u2019un aspect de bloc de branche droit apr\u00e8s ablation sugg\u00e8re l\u2019efficacit\u00e9 de la proc\u00e9dure.","ecg_info_post_answer":"<img class=\"alignnone wp-image-10359 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/page-401-1024x535.png\" alt=\"\" width=\"800\" height=\"418\" \/>"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Trac\u00e9 7.13: Maladie d\u2019ebstein avec pr\u00e9-excitation - 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-7-13-maladie-debstein-avec-pre-excitation\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 7.13: Maladie d\u2019ebstein avec pr\u00e9-excitation - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-13-maladie-debstein-avec-pre-excitation\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\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-7-13-maladie-debstein-avec-pre-excitation\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-maladie-debstein-avec-pre-excitation\/\",\"name\":\"Trac\u00e9 7.13: Maladie d\u2019ebstein avec pr\u00e9-excitation - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\/\/cardiocases.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-maladie-debstein-avec-pre-excitation\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-maladie-debstein-avec-pre-excitation\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-13-ecg-3-scaled.jpeg\",\"datePublished\":\"2026-04-03T14:23:21+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-maladie-debstein-avec-pre-excitation\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-maladie-debstein-avec-pre-excitation\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-maladie-debstein-avec-pre-excitation\/#primaryimage\",\"url\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-13-ecg-3-scaled.jpeg\",\"contentUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-13-ecg-3-scaled.jpeg\",\"width\":2560,\"height\":1316},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-maladie-debstein-avec-pre-excitation\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/cardiocases.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trac\u00e9 7.13: Maladie d\u2019ebstein avec pr\u00e9-excitation\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/cardiocases.com\/#website\",\"url\":\"https:\/\/cardiocases.com\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker &amp; 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