{"id":10906,"date":"2026-06-29T10:45:11","date_gmt":"2026-06-29T10:45:11","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&#038;p=10906"},"modified":"2026-07-02T11:35:35","modified_gmt":"2026-07-02T11:35:35","slug":"trace-7-10-wolff-parkinson-white-and-av-block","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-10-wolff-parkinson-white-and-av-block\/","title":{"rendered":"Trace 7.10: Wolff\u2013parkinson\u2013white and AV-block"},"content":{"rendered":"","protected":false},"featured_media":9775,"template":"","ecg_case_type":[256],"language_ecgcase":[258],"class_list":["post-10906","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-junctional-tachycardia","language_ecgcase-english"],"acf":{"ecg_case_title":"Trace 7.10: Wolff\u2013parkinson\u2013white and AV-block","patient_description":"79-year-old man with no known history or intimation of palpitations, hospitalized for multiple lipothymia episodes;","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":"sinus rhythm","correct_answer":["B","E"],"ecg_image":9775,"ecg_description":"This first tracing performed on arrival in the emergency department shows a typical tracing of left lateral accessory pathway (short PR and delta wave) with a major pre-excitation pattern and a very broad QRS;","ecg_info_box":"A patient with an anterograde permeable accessory pathway exhibits a fully preexcited pattern (maximum pre-excitation) following the occurrence of a conduction block on the nodo-Hisian pathway. The accessory pathway typically has a protective effect in this setting.","commentary_ecg":"In a patient with Wolff-Parkinson-White syndrome, sinus rhythm is usually conducted to the ventricles through two different pathways; the atrioventricular node and the bundle of Kent, the QRS reflects fusion of these two activations. The present case shows a rare case of complete atrioventricular block on the Hisian pathway associated with a second degree block on the accessory pathway. The anterograde conduction is therefore interrupted in a paroxysmal manner leading to the occurrence of dizzy-spells. The complete atrioventricular block could already be suspected given the completely preexcited pattern on the first tracing, which is a rare occurrence in the context of a left lateral accessory pathway. Patients with Wolff-Parkinson-White syndrome complain much more of palpitations and episodes of tachycardia than of issues related to bradycardia. Indeed, the accessory pathway normally has a protective effect during the occurrence of a conduction block on the nodo-Hisian pathway. In the presence of a syncopal episode, the occurrence of a rapid tachycardia (orthodromic, antidromic or atrial fibrillation) is generally suspected. In this patient, a conduction disorder occurring on both pathways was responsible for the described symptoms. A dual-chamber pacemaker was implanted and remotely-conducted controls showed a high percentage of ventricular pacing indicating the presence of a permanent conduction disorder.","ecg_info_post_answer":"<img class=\"alignnone wp-image-10472 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-7-10-ecg2-1024x722.png\" alt=\"\" width=\"800\" height=\"564\" \/>\r\n\r\n<strong>Trace description\u00a0<\/strong>\r\n\r\nOn this second tracing, there are blocked sinus P waves and P waves followed by a pre-excited ventricle identical to those of the previous tracing; this tracing suggests the presence of a complete block of the normal atrioventricular conduction pathways explaining the maximum pre-excitation pattern (exclusive conduction by the accessory pathway) and a second degree block in the bundle of Kent (alternation between conducted P waves and blocked P waves);\r\n\r\n<img class=\"alignnone wp-image-10930 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/06\/trace-7-10-ecg-en-e1782740707381-1024x391.jpg\" alt=\"\" width=\"800\" height=\"305\" \/>"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Trace 7.10: Wolff\u2013parkinson\u2013white and AV-block - 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-7-10-wolff-parkinson-white-and-av-block\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trace 7.10: Wolff\u2013parkinson\u2013white and AV-block - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-7-10-wolff-parkinson-white-and-av-block\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-07-02T11:35:35+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-7-10-ecg.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1237\" \/>\n\t<meta property=\"og:image:height\" content=\"775\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\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-7-10-wolff-parkinson-white-and-av-block\\\/\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-10-wolff-parkinson-white-and-av-block\\\/\",\"name\":\"Trace 7.10: Wolff\u2013parkinson\u2013white and AV-block - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-10-wolff-parkinson-white-and-av-block\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-10-wolff-parkinson-white-and-av-block\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-7-10-ecg.png\",\"datePublished\":\"2026-06-29T10:45:11+00:00\",\"dateModified\":\"2026-07-02T11:35:35+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-10-wolff-parkinson-white-and-av-block\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-10-wolff-parkinson-white-and-av-block\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-10-wolff-parkinson-white-and-av-block\\\/#primaryimage\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-7-10-ecg.png\",\"contentUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-7-10-ecg.png\",\"width\":1237,\"height\":775},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-7-10-wolff-parkinson-white-and-av-block\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/cardiocases.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trace 7.10: Wolff\u2013parkinson\u2013white and AV-block\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker &amp; 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