{"id":11147,"date":"2026-07-02T12:32:11","date_gmt":"2026-07-02T12:32:11","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&#038;p=11147"},"modified":"2026-07-02T11:33:51","modified_gmt":"2026-07-02T11:33:51","slug":"trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm\/","title":{"rendered":"Trace 4.12: Programming atrial arrhythmia fall-back algorithm"},"content":{"rendered":"","protected":false},"featured_media":9686,"template":"","ecg_case_type":[253],"language_ecgcase":[258],"class_list":["post-11147","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-cardiac-pacing","language_ecgcase-english"],"acf":{"ecg_case_title":"Trace 4.12: Programming atrial arrhythmia fall-back algorithm","patient_description":"Same patient as in the previous case","quiz_question":"Regarding this ECG, which of the following is\/are the correct answer(s)?","quiz_answer_1":"Initially, no mode switching due to atrial arrhythmia","quiz_answer_2":"Mode switch at the end of the ECG","quiz_answer_3":"Sinus tachycardia","quiz_answer_4":"Pacemaker mediated tachycardia","quiz_answer_5":"Ventricular tachycardia","correct_answer":["A","B"],"ecg_image":9686,"ecg_description":"The initial trace was identical to the previous one; ventricular rhythm was normalized with a decrease in the pacing rate;","ecg_info_box":"A mode-switch algorithm (the characteristics of which vary by manufacturer) requires a certain number of rapid atrial cycles to occur before it diagnoses atrial arrhythmia and switches to asynchronous mode. It is therefore common to observe a few cycles of rapid ventricular pacing at the onset of an episode of atrial fibrillation.","commentary_ecg":"-","ecg_info_post_answer":"&nbsp;\r\n\r\n<img class=\"alignnone wp-image-10431 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-4-12-ecg2.png\" alt=\"\" width=\"877\" height=\"783\" \/>\r\n\r\n<strong>Trace description\u00a0<\/strong>\r\n\r\nThe EGM shows the deceleration and stabilization of the stimulation rate following programming of the mode-switching algorithm;\r\n\r\n&nbsp;\r\n\r\n<strong>Commentary<\/strong>\r\n\r\nThese waveforms show the normal operation of a dual-chamber pacemaker during an episode of atrial fibrillation; programming the mode switch allows a return to a more physiological heart rate than in the previous waveforms. To prevent a sudden drop in ventricular rate, the return to the base rate or the controlled rate is gradual.\r\n\r\nThe ideal mode-switching algorithm has the following characteristics: 1) rapid triggering to avoid prolonged rapid ventricular pacing during the initial detection phase of the arrhythmia; 2) the ability to quickly switch back to a synchronous mode at the end of the arrhythmia episode; 3) good ability to detect atrial arrhythmias even in the presence of atrial signals of varying amplitude and frequency; 4) ability to avoid mode switches in response to cross-talk, noise, or sinus tachycardia.\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n<img class=\"alignnone wp-image-10432 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-4-12-ecg3.png\" alt=\"\" width=\"873\" height=\"769\" \/>\r\n\r\n<strong>Trace description\u00a0<\/strong>\r\n\r\nThe EGM confirms the diagnosis of AF with a few stimulated cycles when the rate reaches the programmed minimum rate;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n<img class=\"alignnone wp-image-10433 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-4-12-ecg4-1024x610.png\" alt=\"\" width=\"800\" height=\"477\" \/>\r\n\r\n<strong>Trace description<\/strong>\r\n\r\nSlowing the pacing rate allows the spontaneous rhythm to resume; prolonging ventricular diastole makes it easier to detect a rapid, disorganized atrial arrhythmia; ventricular pacing now occurs only during the few prolonged diastoles (slow AF);"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Trace 4.12: Programming atrial arrhythmia fall-back algorithm - 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-4-12-programming-atrial-arrhythmia-fall-back-algorithm\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trace 4.12: Programming atrial arrhythmia fall-back algorithm - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-12-ecg-scaled-e1782936787996-1024x619.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"619\" \/>\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-4-12-programming-atrial-arrhythmia-fall-back-algorithm\\\/\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm\\\/\",\"name\":\"Trace 4.12: Programming atrial arrhythmia fall-back algorithm - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-4-12-ecg-scaled-e1782936787996.png\",\"datePublished\":\"2026-07-02T12:32:11+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm\\\/#primaryimage\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-4-12-ecg-scaled-e1782936787996.png\",\"contentUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/trace-4-12-ecg-scaled-e1782936787996.png\",\"width\":2560,\"height\":1547},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/ecg_case\\\/trace-4-12-programming-atrial-arrhythmia-fall-back-algorithm\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/cardiocases.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trace 4.12: Programming atrial arrhythmia fall-back algorithm\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker &amp; 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