{"id":10275,"date":"2026-04-04T14:19:00","date_gmt":"2026-04-04T14:19:00","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10275"},"modified":"2026-04-04T14:19:00","modified_gmt":"2026-04-04T14:19:00","slug":"trace-8-12-esv-tres-precoce-et-risque-de-fibrillation-ventriculaire","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-8-12-esv-tres-precoce-et-risque-de-fibrillation-ventriculaire\/","title":{"rendered":"Trac\u00e9 8.12: Esv tr\u00e8s pr\u00e9coce et risque de fibrillation ventriculaire"},"content":{"rendered":"","protected":false},"featured_media":10274,"template":"","ecg_case_type":[257],"language_ecgcase":[259],"class_list":["post-10275","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-ventricular-tachycardia","language_ecgcase-french"],"acf":{"ecg_case_title":"Trac\u00e9 8.12: Esv tr\u00e8s pr\u00e9coce et risque de fibrillation ventriculaire","patient_description":"Homme de 48 ans, avec ant\u00e9c\u00e9dent d\u2019infarctus inf\u00e9rieur; hospitalisation \u00e0 la suite de la survenue de 2 \u00e9pisodes de syncope traumatisante; enregistrement de ce trac\u00e9","quiz_question":"Sur cet ECG, on retrouve:","quiz_answer_1":"des signes d\u2019hypertrophie ventriculaire gauche","quiz_answer_2":"des extrasystoles ventriculaires \u00e0 couplage court","quiz_answer_3":"des extrasystoles ventriculaires \u00e0 retard gauche","quiz_answer_4":"des extrasystoles ventriculaires \u00e0 retard droit","quiz_answer_5":"des doublets ventriculaires","correct_answer":["B","C"],"ecg_image":10274,"ecg_description":"Rythme sinusal (onde P positive en DI, DII, V5, V6 et n\u00e9gative en aVR); QRS fin avec probable s\u00e9quelle inf\u00e9rieure; extrasystoles ventriculaires tr\u00e8s pr\u00e9coces car survenant dans la phase initiale ascendante de l\u2019onde T; aspect de retard gauche, axe sup\u00e9rieur, avec tr\u00e8s probable origine ventriculaire droite car transition tardive (en V5);","ecg_info_box":"Il existe 2 types distincts de d\u00e9marrage pour une fibrillation ventriculaire: 1) comme sur ce trac\u00e9, fibrillation ventriculaire inaugurale avec un d\u00e9marrage abrupt sur une extrasystole ventriculaire plus ou moins pr\u00e9coce; 2) \u00e9pisode initial de tachycardie ventriculaire d\u00e9g\u00e9n\u00e9rant dans un second temps en fibrillation ventriculaire. ","commentary_ecg":"L\u2019aspect retrouv\u00e9 sur ce trac\u00e9 correspond \u00e0 une extrasystolie extr\u00eamement pr\u00e9coce, provenant du r\u00e9seau de Purkinje ventriculaire droit distal engendrant une fibrillation ventriculaire. Le r\u00e9seau de Purkinje chemine dans l\u2019endocarde et se divise en une branche fine ventriculaire droite et 2 branches plus \u00e9paisses ventriculaires gauches avec de nombreuses ramifications ce qui permet une activation rapide de la masse ventriculaire. Il existe aujourd\u2019hui un certain nombre d\u2019\u00e9tudes d\u00e9montrant le r\u00f4le central du r\u00e9seau de Purkinje dans la gen\u00e8se et l\u2019entretien des fibrillations ventriculaires conduisant \u00e0 la mort subite. Le caract\u00e8re arythmog\u00e8ne des cellules du r\u00e9seau de Purkinje r\u00e9side dans une sensibilit\u00e9 plus importante aux post- d\u00e9polarisations pr\u00e9coces par rapport aux cellules myocardiques environnantes. L\u2019aspect des extrasystoles provenant du Purkinje ventriculaire droit est relativement homog\u00e8ne alors qu\u2019il est plus variable pour le Purkinje ventriculaire gauche en rapport avec une arborisation plus riche et plus complexe. Lors d\u2019une exploration \u00e9lectrophysiologique, un potentiel caract\u00e9ristique peut \u00eatre enregistr\u00e9 au niveau du r\u00e9seau de Purkinje responsable de l\u2019arythmie; il constitue la cible privil\u00e9gi\u00e9e des proc\u00e9dures d\u2019ablation.\r\n","ecg_info_post_answer":"\"\"\r\n\r\n \r\n\r\n \r\n\r\n \r\n\r\n \r\n\r\n\"\"\r\n\r\nDescription trac\u00e9<\/strong>\r\n\r\nSuivi t\u00e9l\u00e9m\u00e9trique et trac\u00e9 enregistr\u00e9 au cours d\u2019un arr\u00eat cardiocirculatoire n\u00e9cessitant un choc \u00e9lectrique en urgence; extrasystole ventriculaire identique au trac\u00e9 pr\u00e9c\u00e9dent faisant d\u00e9g\u00e9n\u00e9rer le rythme en fibrillation ventriculaire;"},"yoast_head":"\nTrac\u00e9 8.12: Esv tr\u00e8s pr\u00e9coce et risque de fibrillation 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-8-12-esv-tres-precoce-et-risque-de-fibrillation-ventriculaire\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 8.12: Esv tr\u00e8s pr\u00e9coce et risque de fibrillation ventriculaire - 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