{"id":10782,"date":"2026-06-28T05:46:39","date_gmt":"2026-06-28T05:46:39","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10782"},"modified":"2026-07-02T11:46:50","modified_gmt":"2026-07-02T11:46:50","slug":"trace-1-5-atrial-flutter-and-av-conduction-problems","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-5-atrial-flutter-and-av-conduction-problems\/","title":{"rendered":"Trace 1.5: Atrial flutter and AV-conduction problems"},"content":{"rendered":"","protected":false},"featured_media":0,"template":"","ecg_case_type":[250],"language_ecgcase":[258],"class_list":["post-10782","ecg_case","type-ecg_case","status-publish","hentry","ecg_case_type-atrioventricular-block","language_ecgcase-english"],"acf":{"ecg_case_title":"Trace 1.5: Atrial flutter and AV-conduction problems","patient_description":"78-year-old man with arterial hypertension and fatigue","quiz_question":"Which answer(s) is(are) true regarding the diagnosis(es) on this ECG upon entry in the cardiology department?","quiz_answer_1":"sinus rhythm","quiz_answer_2":"right ventricular hypertrophy","quiz_answer_3":"atrial flutter","quiz_answer_4":"right atrial enlargement","quiz_answer_5":"atrial fibrillation","correct_answer":["C"],"ecg_image":11050,"ecg_description":"This tracing shows a bradycardia with a ventricular rate of 40 bpm; common atrial flutter pattern (sawtooth in inferior leads, positive atrial activity in V1 and negative in V6); incomplete right bundle branch block; the QRS complexes are slow and regular corresponding to an altered atrioventricular conduction (absence of fixed ratio between atrial and ventricular activities);","ecg_info_box":"A second-degree AV block type 1 corresponds in the majority of instances to a conduction disorder located in the atrioventricular node and to an exaggeration of decremental conduction. This location explains the predominantly normal morphology of the QRS complexes. Electrophysiological study hence reveals a gradual prolongation of the AH interval, followed by a blocked atrial activity but not followed by a His potential (supra-Hisian block).","commentary_ecg":"-","ecg_info_post_answer":" \r\n\r\n \r\n\r\n\"\"\r\n\r\nTrace description<\/strong>\r\n\r\nThis patient underwent an ablation of the cavo-tricuspid isthmus; the next tracing was recorded after the ablation procedure.\r\n\r\n \r\n\r\nQuestion<\/strong>\r\n\r\nWhat do we see on the second ECG?\r\n\r\nA. left bundle branch block\r\n\r\nB. right bundle branch block + left anterior hemiblock\r\n\r\nC. thirddegree AV-block\r\n\r\nD. second degree AV block type Mobitz 2\r\n\r\nE. second degree AV block type Mobitz 1\r\n\r\n \r\n\r\n \r\n\r\n \r\n\r\n \r\n\r\n \r\n\r\nCorrect answer: E. Atrial sinus activity and second-degree AV block with Wenckebach periodicity;\r\n\r\n \r\n\r\nCommentaires<\/strong>\r\n\r\nThis patient presented an atrial flutter and a high-grade atrioventricular conduction disorder, which is characterized by a slow ventricular rate and a lack of direct relationship between atrial activities and ventricular activities. The highlighting of a second-degree AV block after return to sinus rhythm confirms the presence of this likely junctional conduction disorder (Wenckebach periods with a significant increment in PR interval suggesting a nodal block). This patient was not under any treatment aimed at slowing atrioventricular conduction. The electrical pattern evolved toward an escalation of the conduction disorder with 2:1 atrioventricular rhythm and symptomatic bradycardia of 30 beats\/minute. The patient therefore underwent implantation of a dual-chamber pacemaker.\r\n\r\n\"\""},"yoast_head":"\nTrace 1.5: Atrial flutter and AV-conduction problems - 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-1-5-atrial-flutter-and-av-conduction-problems\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trace 1.5: Atrial flutter and AV-conduction problems - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-5-atrial-flutter-and-av-conduction-problems\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-07-02T11:46:50+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-1-5-atrial-flutter-and-av-conduction-problems\\\/\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-1-5-atrial-flutter-and-av-conduction-problems\\\/\",\"name\":\"Trace 1.5: Atrial flutter and AV-conduction problems - 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