{"id":10903,"date":"2026-06-29T13:44:18","date_gmt":"2026-06-29T13:44:18","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10903"},"modified":"2026-06-29T13:44:19","modified_gmt":"2026-06-29T13:44:19","slug":"trace-7-13-ebstein-disease-with-pre-excitation","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/","title":{"rendered":"Trace 7.13: Ebstein disease with pre-excitation"},"content":{"rendered":"","protected":false},"featured_media":9781,"template":"","ecg_case_type":[256],"language_ecgcase":[258],"class_list":["post-10903","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-junctional-tachycardia","language_ecgcase-english"],"acf":{"ecg_case_title":"Trace 7.13: Ebstein disease with pre-excitation","patient_description":"Young girl 11 years of age with Ebstein\u2019s disease and an accessory pathway; stable cardiovascular condition with some episodes of paroxysmal palpitations;","quiz_question":"What is(are) the possible diagnosis(es) on this ECG?","quiz_answer_1":"right bundle branch block","quiz_answer_2":"accessory pathway","quiz_answer_3":"sequela of posterior necrosis","quiz_answer_4":"sequela of anterior necrosis","quiz_answer_5":"left bundle branch block","correct_answer":["B"],"ecg_image":9781,"ecg_description":"Sinus rhythm; pre-excitation pattern with very short PR interval, delta wave; left axis deviation of the QRS; Qs pattern in V1, QR in V2; probable right posteroseptal accessory pathway;","ecg_info_box":"Ebstein\u2019s disease is the congenital heart disease in which observation of an accessory pathway is the most common. Pre-excitation eliminates the typical pattern of right bundle branch block. The PR interval is generally longer than for a traditional accessory pathway and the QRS complex often shows very little pre-excitation.","commentary_ecg":"Ebstein\u2019s disease is classically characterized by an abnormal development of the tricuspid valve, the septal leaf being displaced into the right ventricle. A surgical correction is often necessary in the presence of significant valvular regurgitation, or an associated cyanosis (by inter-atrial shunt) and\/or other associated anatomical abnormalities. In adolescence and adulthood, disease evolution is marked by the common occurrence of arrhythmia episodes.\r\n\r\nEbstein\u2019s disease is a congenital heart disease where presence of an accessory pathway is the most common observation since estimated between 10 and 40% (versus less than 0.1% in the general population). The vast majority of these accessory pathways are located on the right and primarily at the level of the posteroseptal or posterolateral aspect of the tricuspid annulus. The diagnosis is sometimes difficult to make on the electrocardiogram. Indeed, a major intra-atrial conduction delay is frequent resulting in a prolonged period between sinus node and atrial portion of the accessory pathway. These accessory pathways are often long and have slow conduction velocities. This results in a longer PR than for a traditional accessory pathway and a minimally pre-excited QRS complex. This is not the case in this patient where the PR interval is very short and the pre-excitation easily visualized. In addition, a considerable number of patients exhibit several accessory pathways that render localization on the electrocardiogram difficult.\r\n\r\nIt is possible, as in this patient, to highlight certain electrocardiographic characteristics. Pre-excitation suppresses the typical pattern of right bundle branch block observed in this type of heart disease, with in general a left axis deviation of the QRS in the frontal plane and QS or rS morphology in V1. The absence of a right bundle branch block on the surface electrocardiogram should therefore suggest the presence of an accessory pathway. Similarly, the reappearance of a right bundle branch block pattern after ablation suggests the effectiveness of the procedure.","ecg_info_post_answer":"\"\""},"yoast_head":"\nTrace 7.13: Ebstein disease with pre-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-ebstein-disease-with-pre-excitation\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trace 7.13: Ebstein disease with pre-excitation - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-06-29T13:44:19+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-13-ecg-3-scaled.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1316\" \/>\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-7-13-ebstein-disease-with-pre-excitation\\\/\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-13-ebstein-disease-with-pre-excitation\\\/\",\"name\":\"Trace 7.13: Ebstein disease with pre-excitation - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-13-ebstein-disease-with-pre-excitation\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-13-ebstein-disease-with-pre-excitation\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-7-13-ecg-scaled.jpeg\",\"datePublished\":\"2026-06-29T13:44:18+00:00\",\"dateModified\":\"2026-06-29T13:44:19+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-13-ebstein-disease-with-pre-excitation\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-13-ebstein-disease-with-pre-excitation\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-13-ebstein-disease-with-pre-excitation\\\/#primaryimage\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-7-13-ecg-scaled.jpeg\",\"contentUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-7-13-ecg-scaled.jpeg\",\"width\":2560,\"height\":1316},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-13-ebstein-disease-with-pre-excitation\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/cardiocases.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trace 7.13: Ebstein disease with pre-excitation\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker & ICD learning \u2014 built by electrophysiologists\",\"publisher\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/cardiocases.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#organization\",\"name\":\"Cardiocases\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2025\\\/07\\\/cardiocases_logo.png\",\"contentUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2025\\\/07\\\/cardiocases_logo.png\",\"width\":1755,\"height\":499,\"caption\":\"Cardiocases\"},\"image\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.linkedin.com\\\/company\\\/cardiocases\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Trace 7.13: Ebstein disease with pre-excitation - Cardiocases","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/","og_locale":"fr_FR","og_type":"article","og_title":"Trace 7.13: Ebstein disease with pre-excitation - Cardiocases","og_url":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/","og_site_name":"Cardiocases","article_modified_time":"2026-06-29T13:44:19+00:00","og_image":[{"width":2560,"height":1316,"url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-13-ecg-3-scaled.jpeg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Dur\u00e9e de lecture estim\u00e9e":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/","url":"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/","name":"Trace 7.13: Ebstein disease with pre-excitation - Cardiocases","isPartOf":{"@id":"https:\/\/cardiocases.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/#primaryimage"},"image":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/#primaryimage"},"thumbnailUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-13-ecg-scaled.jpeg","datePublished":"2026-06-29T13:44:18+00:00","dateModified":"2026-06-29T13:44:19+00:00","breadcrumb":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/cardiocases.com\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/#primaryimage","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-13-ecg-scaled.jpeg","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-13-ecg-scaled.jpeg","width":2560,"height":1316},{"@type":"BreadcrumbList","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-7-13-ebstein-disease-with-pre-excitation\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/cardiocases.com\/"},{"@type":"ListItem","position":2,"name":"Trace 7.13: Ebstein disease with pre-excitation"}]},{"@type":"WebSite","@id":"https:\/\/cardiocases.com\/#website","url":"https:\/\/cardiocases.com\/","name":"Cardiocases","description":"Real cardiac device traces, pacemaker & ICD learning \u2014 built by electrophysiologists","publisher":{"@id":"https:\/\/cardiocases.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/cardiocases.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/cardiocases.com\/#organization","name":"Cardiocases","url":"https:\/\/cardiocases.com\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","width":1755,"height":499,"caption":"Cardiocases"},"image":{"@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.linkedin.com\/company\/cardiocases\/"]}]}},"_links":{"self":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case\/10903","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case"}],"about":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/types\/ecg_case"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media\/9781"}],"wp:attachment":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media?parent=10903"}],"wp:term":[{"taxonomy":"ecg_case_type","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case_type?post=10903"},{"taxonomy":"language_ecgcase","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/language_ecgcase?post=10903"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}