{"id":10876,"date":"2026-06-29T03:17:53","date_gmt":"2026-06-29T03:17:53","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&#038;p=10876"},"modified":"2026-07-02T11:37:17","modified_gmt":"2026-07-02T11:37:17","slug":"trace-6-3-atrial-fibrillation","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-6-3-atrial-fibrillation\/","title":{"rendered":"Trace 6.3: Atrial fibrillation"},"content":{"rendered":"","protected":false},"featured_media":9725,"template":"","ecg_case_type":[255],"language_ecgcase":[258],"class_list":["post-10876","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-atrial-fibrillation-atrial-flutter-atrial-tachycardia","language_ecgcase-english"],"acf":{"ecg_case_title":"Trace 6.3: Atrial fibrillation","patient_description":"65-year-old male with no prior history; consultation for palpitations occurring since a few days;","quiz_question":"What abnormality(ies) are found on this tracing?","quiz_answer_1":"sinus node dysfunction","quiz_answer_2":"atrial fibrillation","quiz_answer_3":"flutter originating from the left atrium","quiz_answer_4":"flutter originating from the right atrium","quiz_answer_5":"atrial tachycardia","correct_answer":["B"],"ecg_image":9725,"ecg_description":"Characteristic pattern of atrial fibrillation; irregular tachycardia with narrow QRS; rapid, disorganized atrial activity with baseline tremor; well-identifiable atrial activity during long diastoles (long RR interval);","ecg_info_box":"During atrial fibrillation, the electrocardiogram typically shows rapid, irregular and disorganized atrial activity along with narrow, rapid and irregular QRS complexes.","commentary_ecg":"Atrial fibrillation is the most commonly observed rhythm disorder in daily cardiology practice and corresponds to a complete disorganization of the electrical activity of the atria leading to the loss of atrial systole.\r\n\r\nDuring an atrial fibrillation episode, the electrocardiogram typically shows: 1) a rapid, disorganized and irregular atrial activity (between 350 and 600 bpm); the atrial waves are difficult to analyze and produce continuous and permanent undulations of the baseline; 2) the QRS complexes are mostly narrow, irregular (justifying the name of complete arrhythmia by atrial fibrillation) with an increased rate > 100 bpm but much lower than the atrial rate. The RR intervals are of unequal duration and appear not to obey any specific rule or periodicity. This irregularity, very evocative of the diagnosis of atrial fibrillation, is secondary to the incessant bombardment of the atrioventricular node by atrial impulses.\r\n\r\nThere are, however, a number of differences in the electrocardiographic pattern depending on the characteristics of the patients. Atrial activity can be of varying amplitude. It is usually of high amplitude in patients with mitral valve disease, congenital heart disease, or with a wall enlargement (coarse AF). The amplitude on average is greater in leads in close proximity to the right atrium (right precordial leads, V1-V3). Conversely, atrial activity can sometimes be very difficult to discern due to a very small amplitude (fine AF), the diagnosis hence being suggested by indirect signs: absence of sinus P waves and irregularity of the ventricles. This often reflects the presence of an old permanent AF. The term fibrillo-flutter is inappropriate and is mistakenly used in presence of an atrial activity with high voltage which appears to be \u201crelatively organized\u201d (most often in V1). By definition, the flutter pattern corresponds to a perfectly regular activity, thus a \u201cslightly irregular\u201d atrial activity hence leading to the diagnosis of atrial fibrillation.\r\n\r\nThe ventricular rate can be regular and slow if associated with an atrioventricular conduction disorder; this is called brady-arrhythmia. A perfectly regular ventricular rhythm suggests the presence of a complete atrioventricular block with most often a junctional escape rhythm. Conversely, when conduction is excellent, the ventricles can be very rapid (> 170 bpm) with often a relatively regular pattern. The ventricular rate can be very high (> 250 bpm) and life-threatening, when the nodal filter does not function in a patient with a very permeable accessory pathway.\r\n\r\nGiven the supraventricular origin of the arrhythmia, the morphology of the QRS complexes is generally identical to that of the QRS complexes in sinus rhythm. The QRS complexes are therefore generally narrow. The occurrence of broad QRS complexes may occur under 3 circumstances:\r\n\r\n1.   in a patient with a permanent bundle branch block,\r\n2.   an intermittent broadening of the QRS may correspond to a conduction aberration occurring following very short RR intervals,\r\n3.   patients with ventricular pre-excitation.\r\n \r\n\r\nThe electrocardiogram after sinus return in this patient shows the presence of a very premature atrial complex in the T wave which frequently constitutes the triggering factor for the occurrence of an atrial arrhythmia episode.","ecg_info_post_answer":"<img class=\"alignnone wp-image-10881 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/06\/trace-6-3-ecg-en-1024x576.jpg\" alt=\"\" width=\"800\" height=\"450\" \/>\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n<img class=\"alignnone wp-image-10441 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-6-3-ecg2-scaled-e1775159573312-1024x721.jpeg\" alt=\"\" width=\"800\" height=\"563\" \/>\r\n\r\n<strong>Trace description<\/strong>\r\n\r\nElectrocardiogram recorded after a spontaneous return in sinus rhythm; widened and bifid P wave in leads I, II, V3, V4 with widened negative component in V1: probable left atrial enlargement; premature atrial extrasystole in the T wave (P\/T) followed by a QRS with conduction aberration;"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Trace 6.3: Atrial fibrillation - 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-6-3-atrial-fibrillation\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trace 6.3: Atrial fibrillation - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-6-3-atrial-fibrillation\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-07-02T11:37:17+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-6-3-ecg-scaled-e1782933542550.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1528\" \/>\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-6-3-atrial-fibrillation\\\/\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-6-3-atrial-fibrillation\\\/\",\"name\":\"Trace 6.3: Atrial fibrillation - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-6-3-atrial-fibrillation\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-6-3-atrial-fibrillation\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-6-3-ecg-scaled-e1782933542550.jpeg\",\"datePublished\":\"2026-06-29T03:17:53+00:00\",\"dateModified\":\"2026-07-02T11:37:17+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-6-3-atrial-fibrillation\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-6-3-atrial-fibrillation\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-6-3-atrial-fibrillation\\\/#primaryimage\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-6-3-ecg-scaled-e1782933542550.jpeg\",\"contentUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-6-3-ecg-scaled-e1782933542550.jpeg\",\"width\":2560,\"height\":1528},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-6-3-atrial-fibrillation\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/cardiocases.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trace 6.3: Atrial fibrillation\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker &amp; 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