{"id":284,"date":"2025-07-13T08:56:22","date_gmt":"2025-07-13T08:56:22","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=284"},"modified":"2026-01-07T09:35:14","modified_gmt":"2026-01-07T09:35:14","slug":"atrial-refractory-periods","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/basic-concepts\/pacemaker\/atrial-refractory-periods\/","title":{"rendered":"Les p\u00e9riodes r\u00e9fractaires atriales"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"284\" class=\"elementor elementor-284\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4db0ad6 e-con-full e-flex e-con e-parent\" data-id=\"4db0ad6\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fcbc559 elementor-widget elementor-widget-heading\" data-id=\"fcbc559\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Les p\u00e9riodes r\u00e9fractaires atriales<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-01b2676 e-con-full e-flex e-con e-parent\" data-id=\"01b2676\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-84dbc0a elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"84dbc0a\" data-element_type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h3&quot;,&quot;h4&quot;,&quot;h5&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;no_headings_message&quot;:&quot;No headings were found on this page.&quot;,&quot;marker_view&quot;:&quot;bullets&quot;,&quot;icon&quot;:{&quot;value&quot;:&quot;fas fa-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;,&quot;rendered_tag&quot;:&quot;&lt;svg class=\\&quot;e-font-icon-svg e-fas-circle\\&quot; viewBox=\\&quot;0 0 512 512\\&quot; xmlns=\\&quot;http:\\\/\\\/www.w3.org\\\/2000\\\/svg\\&quot;&gt;&lt;path d=\\&quot;M256 8C119 8 8 119 8 256s111 248 248 248 248-111 248-248S393 8 256 8z\\&quot;&gt;&lt;\\\/path&gt;&lt;\\\/svg&gt;&quot;},&quot;minimize_box&quot;:&quot;yes&quot;,&quot;minimized_on&quot;:&quot;tablet&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t\t\t\t<h4 class=\"elementor-toc__header-title\">\n\t\t\t\tG\u00e9n\u00e9ralit\u00e9s\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__84dbc0a\" aria-expanded=\"true\" aria-label=\"Ouvrir la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/div>\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__84dbc0a\" aria-expanded=\"true\" aria-label=\"Fermer la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<div id=\"elementor-toc__84dbc0a\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewbox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3eda36d e-con-full e-flex e-con e-parent\" data-id=\"3eda36d\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7f6b959 elementor-widget elementor-widget-heading\" data-id=\"7f6b959\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Informations g\u00e9n\u00e9rales<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b23096f e-con-full e-flex e-con e-parent\" data-id=\"b23096f\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c322354 elementor-widget elementor-widget-heading\" data-id=\"c322354\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Le blanking et la p\u00e9riode r\u00e9fractaire atriale post-atriale<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-27f05e7 elementor-widget elementor-widget-text-editor\" data-id=\"27f05e7\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Le blanking atrial et la p\u00e9riode r\u00e9fractaire atriale (PRA) interviennent suite \u00e0 des \u00e9v\u00e8nements atriaux stimul\u00e9s ou d\u00e9tect\u00e9s.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3f91951 elementor-widget elementor-widget-image\" data-id=\"3f91951\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_1\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjgwNCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzEucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"585\" height=\"244\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_1.png\" class=\"attachment-large size-large wp-image-6804\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_1.png 585w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_1-300x125.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_1-18x8.png 18w\" sizes=\"(max-width: 585px) 100vw, 585px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0ba22d0 e-con-full e-flex e-con e-parent\" data-id=\"0ba22d0\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-18e5a23 elementor-widget elementor-widget-heading\" data-id=\"18e5a23\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Les p\u00e9riodes r\u00e9fractaires atriales post-ventriculaires<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-88b406a elementor-widget elementor-widget-text-editor\" data-id=\"88b406a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6><span style=\"font-size: 1rem;\">Le blanking atrial post-ventriculaire (BAPV)<\/span><\/h6><p>C\u2019est une p\u00e9riode r\u00e9fractaire absolue appliqu\u00e9e dans l\u2019oreillette apr\u00e8s d\u00e9tection et stimulation ventriculaire. Tout \u00e9v\u00e8nement ventriculaire d\u00e9tect\u00e9 ou stimul\u00e9 relance le BAPV qui est aussi la premi\u00e8re partie de la PRAPV. Le BAPV est limit\u00e9 \u00e0 des valeurs inf\u00e9rieures ou \u00e9gales \u00e0 celles de la PRAPV programm\u00e9e.<\/p><p>Son utilit\u00e9 est d\u2019\u00e9viter la d\u00e9tection, par la chaine atriale :<\/p><ul><li>de l'art\u00e9fact de stimulation ventriculaire\u00a0<\/li><li>de la d\u00e9polarisation du ventricule spontan\u00e9 ou stimul\u00e9<\/li><\/ul><p>Ce blanking est utilis\u00e9 lorsque le stimulateur fonctionne en modes DDD, DDI, VDD et VDI.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3e9774d elementor-widget elementor-widget-image\" data-id=\"3e9774d\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_4.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_4\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjgwMywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzQucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"702\" height=\"305\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_4.png\" class=\"attachment-large size-large wp-image-6803\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_4.png 702w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_4-300x130.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_4-18x8.png 18w\" sizes=\"(max-width: 702px) 100vw, 702px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1df7c5e elementor-widget elementor-widget-text-editor\" data-id=\"1df7c5e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>La p\u00e9riode r\u00e9fractaire atriale post-ventriculaire (PRAPV<\/h6><p>La p\u00e9riode r\u00e9fractaire atriale post-ventriculaire (PRAPV) est d\u00e9clench\u00e9e par une d\u00e9tection ou une stimulation ventriculaire.<\/p><p>Elle intervient lorsque le stimulateur fonctionne en modes DDD, DDI et VDD.<\/p><p>Elle est destin\u00e9e principalement \u00e0 emp\u00eacher la d\u00e9tection d\u2019ondes P r\u00e9trogrades susceptibles de d\u00e9clencher des tachycardies par r\u00e9entr\u00e9e \u00e9lectronique (modes de suivi atrial). Lorsque le stimulateur fonctionne en mode DDI, la PRAPV emp\u00eache l\u2019inhibition atriale par la d\u00e9tection d\u2019ondes P r\u00e9trogrades.<\/p><p>Sa premi\u00e8re partie est occup\u00e9e par le BAPV et est donc r\u00e9fractaire absolue (en fonction des constructeurs). Apr\u00e8s le BAPV, la p\u00e9riode est relative. Durant la PRAPV, des \u00e9v\u00e9nements atriaux intrins\u00e8ques peuvent \u00eatre d\u00e9tect\u00e9s comme \u00e9v\u00e9nements r\u00e9fractaires et identifi\u00e9s sur les enregistrements de marqueurs d\u2019\u00e9v\u00e9nements mais ils n\u2019affectent pas la synchronisation des intervalles de stimulation. Ainsi, un \u00e9v\u00e8nement atrial d\u00e9tect\u00e9 dans cette p\u00e9riode n'induit pas de d\u00e9lai AV. Lorsque le stimulateur fonctionne en modes DDD et DDI, la stimulation atriale pr\u00e9vue n\u2019est pas inhib\u00e9e. e.<\/p><p>Pour \u00e9viter de recycler la stimulation ventriculaire sur une onde P r\u00e9trograde, la PRAPV doit \u00eatre th\u00e9oriquement programm\u00e9e \u00e0 une valeur sup\u00e9rieure au temps de conduction r\u00e9trograde ventriculo-atrial du patient. La valeur moyenne du temps de conduction r\u00e9trograde est comprise entre 220 et 280 ms suivant les patients mais peut parfois \u00eatre encore plus longue avec n\u00e9cessit\u00e9 d'adapter la PRAPV.<\/p><p>Cependant, une PRAPV trop longue peut induire l\u2019apparition d\u2019un bloc 2:1 \u00e0 des fr\u00e9quences intrins\u00e8ques \u00e9lev\u00e9es lorsque le stimulateur fonctionne en mode de suivi atrial (DDD ou VDD). Pour r\u00e9duire le point de 2:1, la PRAPV peut \u00eatre configur\u00e9e pour qu'elle varie en fonction de la fr\u00e9quence indiqu\u00e9e par le capteur (PRAPV modul\u00e9e par le capteur) ou par la fr\u00e9quence atriale moyenne (PRAPV automatique). Les sp\u00e9cificit\u00e9s des r\u00e9glages \u00e0 l'effort seront vues dans un autre chapitre.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-89bce58 elementor-widget elementor-widget-image\" data-id=\"89bce58\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_5.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_5\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjgwMiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzUucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"704\" height=\"652\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_5.png\" class=\"attachment-large size-large wp-image-6802\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_5.png 704w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_5-300x278.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_5-13x12.png 13w\" sizes=\"(max-width: 704px) 100vw, 704px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2d65a9d elementor-widget elementor-widget-image\" data-id=\"2d65a9d\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_6.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_6\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjgwMSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzYucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"675\" height=\"336\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_6.png\" class=\"attachment-large size-large wp-image-6801\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_6.png 675w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_6-300x149.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_6-18x9.png 18w\" sizes=\"(max-width: 675px) 100vw, 675px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5abbdd4 elementor-widget elementor-widget-heading\" data-id=\"5abbdd4\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Informations sp\u00e9cifiques \u00e0 la marque<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3df3d0a elementor-widget elementor-widget-heading\" data-id=\"3df3d0a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">1. La suppression et la p\u00e9riode r\u00e9fractaire post-auriculaire<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-89fad8e elementor-widget elementor-widget-heading\" data-id=\"89fad8e\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Abbott<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-830342e elementor-widget elementor-widget-text-editor\" data-id=\"830342e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Il existe une p\u00e9riode r\u00e9fractaire atriale post-d\u00e9tection atriale programmable (entre 93 et 190 ms, valeur nominale 93 ms).<\/p><p>De m\u00eame, apr\u00e8s une stimulation atriale, il existe une p\u00e9riode r\u00e9fractaire atriale programmable (entre 190 et 470 ms, valeur nominale 190 ms).<\/p><p>Les \u00e9v\u00e9nements qui se produisent pendant cette p\u00e9riode r\u00e9fractaire ne sont pas pris en compte pour le d\u00e9compte des arythmies atriales (calcul de la fr\u00e9quence atriale filtr\u00e9e).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cff8d32 elementor-widget elementor-widget-heading\" data-id=\"cff8d32\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Biotronik<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-00f9c6a elementor-widget elementor-widget-text-editor\" data-id=\"00f9c6a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>La p\u00e9riode r\u00e9fractaire atriale (PRA) intervient suite \u00e0 un \u00e9v\u00e8nement atrial stimul\u00e9 ou d\u00e9tect\u00e9 (en bleu sur l'image) quand il n'est pas en p\u00e9riode r\u00e9fractaire. Elle est programm\u00e9e sur Auto en nominal ce qui veut dire qu'elle est \u00e9gale \u00e0 une valeur fixe de 225 ms mais qu'elle est automatiquement augment\u00e9e si le d\u00e9lai AV est programm\u00e9 plus long que 225 ms. Ce param\u00e8tre est non programmable.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5a3c7c5 elementor-widget elementor-widget-image\" data-id=\"5a3c7c5\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_2.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_2\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjgwMCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzIucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"469\" height=\"370\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_2.png\" class=\"attachment-large size-large wp-image-6800\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_2.png 469w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_2-300x237.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_2-15x12.png 15w\" sizes=\"(max-width: 469px) 100vw, 469px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c442336 elementor-widget elementor-widget-heading\" data-id=\"c442336\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Boston Scientific<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6ccdbd9 elementor-widget elementor-widget-text-editor\" data-id=\"6ccdbd9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Il existe une p\u00e9riode r\u00e9fractaire atriale diff\u00e9rente post-d\u00e9tection et post-stimulation atriale. Ces 2 valeurs ne sont pas programmables.<\/p><p>Apr\u00e8s une d\u00e9tection atriale, il existe une p\u00e9riode r\u00e9fractaire atriale de 85 ms d\u00e9compos\u00e9e en 30 ms de p\u00e9riode r\u00e9fractaire absolue, 40 ms de fen\u00eatre de bruit et 15 ms de p\u00e9riode r\u00e9fractaire absolue.<\/p><p>Apr\u00e8s une stimulation atriale, il existe une p\u00e9riode r\u00e9fractaire atriale de 150 ms d\u00e9compos\u00e9e en 110 ms de p\u00e9riode r\u00e9fractaire absolue et 40 ms de fen\u00eatre de bruit.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5e40a75 elementor-widget elementor-widget-heading\" data-id=\"5e40a75\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Medtronic<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-24dc448 elementor-widget elementor-widget-text-editor\" data-id=\"24dc448\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Si le stimulateur est programm\u00e9 sur un mode MVP, et fonctionne en mode ADI, la p\u00e9riode r\u00e9fractaire atriale est automatiquement ajust\u00e9e \u00e0 75% du cycle cardiaque jusqu\u2019\u00e0 un maximum de 600 ms.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f15edcf elementor-widget elementor-widget-heading\" data-id=\"f15edcf\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Microport<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a2a6192 elementor-widget elementor-widget-text-editor\" data-id=\"a2a6192\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Suite \u00e0 une d\u00e9tection atriale, une p\u00e9riode r\u00e9fractaire de 80 ms est d\u00e9clench\u00e9e \u00e0 l\u2019\u00e9tage atrial. Les 30 premi\u00e8res ms sont une p\u00e9riode r\u00e9fractaire absolue et les 50 ms suivantes sont red\u00e9clenchables automatiquement en cas de d\u00e9tection. La valeur de cette p\u00e9riode n\u2019est pas programmable.<\/p><p>En mode DDD, suite \u00e0 une stimulation atriale, les p\u00e9riodes correspondants au d\u00e9lai AV sont des p\u00e9riodes r\u00e9fractaires absolues \u00e0 l\u2019\u00e9tage atrial.<\/p><p>Suite \u00e0 une d\u00e9tection ou une stimulation atriale, une autre p\u00e9riode r\u00e9fractaire relative est d\u00e9clench\u00e9e \u00e0 l\u2019\u00e9tage atrial. Sa dur\u00e9e est dynamique et est calcul\u00e9e en fonction du rythme atrial. Elle n\u2019est effective qu\u2019apr\u00e8s la fin de la p\u00e9riode r\u00e9fractaire atriale de 80 ms. Elle a pour but de d\u00e9tecter l\u2019acc\u00e9l\u00e9ration du rythme atrial (d\u2019o\u00f9 son nom : fen\u00eatre de DARA).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7c3c6a2 elementor-widget elementor-widget-image\" data-id=\"7c3c6a2\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_3.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_3\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5OSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzMucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"414\" height=\"401\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_3.png\" class=\"attachment-large size-large wp-image-6799\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_3.png 414w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_3-300x291.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_3-12x12.png 12w\" sizes=\"(max-width: 414px) 100vw, 414px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6bb6312 elementor-widget elementor-widget-text-editor\" data-id=\"6bb6312\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Lorsque le mode de stimulation double chambre SafeR est programm\u00e9 et qu\u2019il fonctionne en ADI, une p\u00e9riode r\u00e9fractaire de 150 ms est d\u00e9clench\u00e9e \u00e0 l\u2019\u00e9tage atrial. Les 100 premi\u00e8res ms sont une p\u00e9riode r\u00e9fractaire absolue et les 50 ms suivantes sont red\u00e9clenchables automatiquement. La valeur de cette p\u00e9riode n\u2019est pas programmable.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0a9f5f9 elementor-widget elementor-widget-heading\" data-id=\"0a9f5f9\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">2. Les p\u00e9riodes r\u00e9fractaires atriales post-ventriculaires<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e9152f3 elementor-widget elementor-widget-text-editor\" data-id=\"e9152f3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ol><li>Le blanking atrial post-ventriculaire est programmable pour les 5 compagnies.<\/li><li>Un \u00e9v\u00e9nement atrial survenant dans cette p\u00e9riode n\u2019appara\u00eet pas sur la chaine des marqueurs et est ignor\u00e9 par les fonctions de stimulation antibradycardique pour les stimulateurs Boston Scientific, Abbott et Microport CRM-Sorin.<\/li><li>Un \u00e9v\u00e9nement auriculaire survenant au cours de cette p\u00e9riode appara\u00eet sur la cha\u00eene de marqueurs mais est ignor\u00e9 par les fonctions de stimulation antibradycardique des stimulateurs Biotronik.<\/li><li>Un \u00e9v\u00e9nement atrial survenant dans cette p\u00e9riode appara\u00eet sur la chaine des marqueurs et est int\u00e9gr\u00e9 dans le d\u00e9compte des arythmies atriales pour les stimulateurs Medtronic les plus r\u00e9cents.<\/li><li>Il n'y a pas de PRAPV dans les stimulateurs Microport CRM-Sorin. Elle est remplac\u00e9e par la fen\u00eatre de DARA et la RetroPwatch.<\/li><li>Il n'y a pas de PRAPV apr\u00e8s un ventricule d\u00e9tect\u00e9 (exception pour les ESV) pour les stimulateurs Biotronik.<\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7f69bfe elementor-widget elementor-widget-heading\" data-id=\"7f69bfe\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Abbott<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2fb850d elementor-widget elementor-widget-text-editor\" data-id=\"2fb850d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Le blanking atrial post-ventriculaire<\/span><\/p><p>A la suite d\u2019une stimulation ventriculaire, il existe un blanking atrial de 60 \u00e0 250 ms (valeur nominale, 150 ms). Les \u00e9v\u00e9nements qui se produisent pendant cette p\u00e9riode r\u00e9fractaire ne sont pas pris en compte pour le d\u00e9compte des arythmies atriales (calcul de la fr\u00e9quence atriale filtr\u00e9e).<\/p><p><span style=\"text-decoration: underline;\">La p\u00e9riode r\u00e9fractaire atriale post-ventriculaire (PRAPV)<\/span><\/p><p>La PRAPV est programmable entre 125 et 500 ms (valeur nominale 275 ms).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7cb3f0f elementor-widget elementor-widget-image\" data-id=\"7cb3f0f\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_14-1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_14 (1)\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5MSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzE0LTEucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"506\" height=\"228\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_14-1.png\" class=\"attachment-large size-large wp-image-6791\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_14-1.png 506w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_14-1-300x135.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_14-1-18x8.png 18w\" sizes=\"(max-width: 506px) 100vw, 506px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-27597f0 elementor-widget elementor-widget-text-editor\" data-id=\"27597f0\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>La programmation d\u2019une PRAPV dynamique permet d\u2019adapter la valeur de la PRAPV en fonction de la fr\u00e9quence cardiaque. Il est possible de programmer ce param\u00e8tre sur Arr\u00eat, Faible, Moyen, Elev\u00e9). Il faut \u00e9galement programmer une PRAPV la plus courte (programmable entre 125 et 475 ms, valeur nominale 175 ms).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f3513b9 elementor-widget elementor-widget-image\" data-id=\"f3513b9\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_15-1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_15 (1)\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5MCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzE1LTEucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"503\" height=\"322\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_15-1.png\" class=\"attachment-large size-large wp-image-6790\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_15-1.png 503w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_15-1-300x192.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_15-1-18x12.png 18w\" sizes=\"(max-width: 503px) 100vw, 503px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b48d6b6 elementor-widget elementor-widget-heading\" data-id=\"b48d6b6\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Biotronik<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-37dc6b4 elementor-widget elementor-widget-text-editor\" data-id=\"37dc6b4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Le blanking atrial post-ventriculaire: protection far-field<\/span><\/p><p>C\u2019est une p\u00e9riode r\u00e9fractaire appliqu\u00e9e dans l\u2019oreillette apr\u00e8s d\u00e9tection et stimulation ventriculaire pour \u00e9viter une \u00e9coute crois\u00e9e (protection contre le far-field).<\/p><p>La valeur nominale est de 100 ms (programmable entre 100 et 220 ms) apr\u00e8s un ventricule spontan\u00e9 (VS) et de 150 ms (programmable entre 100 et 220ms) apr\u00e8s un ventricule stimul\u00e9. Si un \u00e9v\u00e8nement tombe dans ce blanking, il est not\u00e9 Ars (PFF) mais ne d\u00e9clenche pas de d\u00e9lai AV et n\u2019est pas comptabilis\u00e9 pour le diagnostic des arythmies atriales.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e387216 elementor-widget elementor-widget-image\" data-id=\"e387216\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_7.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_7\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5OCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzcucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"467\" height=\"373\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_7.png\" class=\"attachment-large size-large wp-image-6798\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_7.png 467w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_7-300x240.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_7-15x12.png 15w\" sizes=\"(max-width: 467px) 100vw, 467px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c3880f0 elementor-widget elementor-widget-text-editor\" data-id=\"c3880f0\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">La p\u00e9riode r\u00e9fractaire atriale post-ventriculaire (PRAPV)<\/span><\/p><p>La p\u00e9riode r\u00e9fractaire atriale post-ventriculaire (PRAPV) est uniquement d\u00e9clench\u00e9e par une stimulation ventriculaire dans un stimulateur Biotronik et pas sur une d\u00e9tection ventriculaire (VS). Elle est \u00e9galement d\u00e9clench\u00e9e par une extrasystole ventriculaire.<\/p><p>La PRAPV est programmable sur Auto ou de 175 \u00e0 600 ms. La PVARP post extrasystole est allong\u00e9e de 150 ms (PVARP + 150 ms).<\/p><p>Quand la PRAPV est programm\u00e9e sur Auto, la PVARP nominale est de 250 ms. La PVARP est prolong\u00e9e de 50 ms pendant 7 jours quand un \u00e9pisode de TRE est diagnostiqu\u00e9 et trait\u00e9. Si aucune TRE ne survient pendant 7 jours, la PRAPV est diminu\u00e9e de 50 ms jusqu\u2019\u00e0 une valeur minimale de 175 ms).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-929cfe6 elementor-widget elementor-widget-image\" data-id=\"929cfe6\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_8.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_8\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5NywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzgucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"403\" height=\"322\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_8.png\" class=\"attachment-large size-large wp-image-6797\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_8.png 403w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_8-300x240.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_8-15x12.png 15w\" sizes=\"(max-width: 403px) 100vw, 403px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b86d906 elementor-widget elementor-widget-heading\" data-id=\"b86d906\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Boston Scientific<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8fa5883 elementor-widget elementor-widget-text-editor\" data-id=\"8fa5883\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Le blanking atrial post-ventriculaire<\/span><\/p><p>Ce blanking peut \u00eatre programm\u00e9 sur une valeur fixe ou sur SMART. Il existe un blanking atrial diff\u00e9rent post-stimulation et post-d\u00e9tection ventriculaire.<\/p><p>La programmation SMART a pour objectif de r\u00e9duire les dur\u00e9es de blanking tout en r\u00e9duisant le risque d\u2019\u00e9coute crois\u00e9e avec :<\/p><ul><li>la suppression de la fen\u00eatre de bruit de la p\u00e9riode de blanking<\/li><li>augmentation du seuil de contr\u00f4le automatique de gain pour \u00e9viter l\u2019\u00e9coute crois\u00e9e (CAG augment\u00e9 \u00e0 3\/8 du pic mesur\u00e9 conduisant temporairement \u00e0 une sensibilit\u00e9 moindre)<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4e1e9da elementor-widget elementor-widget-image\" data-id=\"4e1e9da\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_9-1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_9 (1)\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5NiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzktMS5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"582\" height=\"252\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_9-1.png\" class=\"attachment-large size-large wp-image-6796\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_9-1.png 582w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_9-1-300x130.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_9-1-18x8.png 18w\" sizes=\"(max-width: 582px) 100vw, 582px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-173b436 elementor-widget elementor-widget-text-editor\" data-id=\"173b436\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Le blanking atrial post-stimulation ventriculaire peut \u00eatre programm\u00e9 sur une valeur fixe (valeur nominale 125 ms) ou sur SMART (dur\u00e9e 37.5 ms sans fen\u00eatre de bruit).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f125df9 elementor-widget elementor-widget-image\" data-id=\"f125df9\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_10-1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_10 (1)\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5NSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzEwLTEucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"314\" height=\"141\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_10-1.png\" class=\"attachment-large size-large wp-image-6795\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_10-1.png 314w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_10-1-300x135.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_10-1-18x8.png 18w\" sizes=\"(max-width: 314px) 100vw, 314px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5a97948 elementor-widget elementor-widget-text-editor\" data-id=\"5a97948\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Le blanking atrial post-d\u00e9tection ventriculaire peut \u00eatre programm\u00e9 sur une valeur fixe (valeur nominale 45 ms) ou sur SMART (dur\u00e9e 15 ms sans fen\u00eatre de bruit).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1be30f9 elementor-widget elementor-widget-image\" data-id=\"1be30f9\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_11-1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_11 (1)\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5NCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzExLTEucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"337\" height=\"109\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_11-1.png\" class=\"attachment-large size-large wp-image-6794\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_11-1.png 337w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_11-1-300x97.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_11-1-18x6.png 18w\" sizes=\"(max-width: 337px) 100vw, 337px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-776b426 elementor-widget elementor-widget-heading\" data-id=\"776b426\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Medtronic<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-de54b25 elementor-widget elementor-widget-text-editor\" data-id=\"de54b25\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Le blanking atrial post-ventriculaire (BAPV)<\/span><\/p><p>Sur la gamme des pacemakers Adapta et des pacemakers plus anciens, un \u00e9v\u00e9nement atrial survenant dans cette p\u00e9riode n\u2019appara\u00eet pas sur la chaine des marqueurs et est ignor\u00e9 par les fonctions de stimulation antibradycardique.<\/p><p>Pour les stimulateurs les plus r\u00e9cents, comme l\u2019Ensura ou l\u2019Advisa (plateforme commune avec celle des d\u00e9fibrillateurs), le comportement en r\u00e9ponse \u00e0 un \u00e9v\u00e9nement atrial survenant dans cette p\u00e9riode diff\u00e8re et est d\u00e9termin\u00e9 en fonction de deux param\u00e8tres programmables : l\u2019intervalle BAPV et la m\u00e9thode BAPV.<\/p><p>Si la m\u00e9thode BAPV est programm\u00e9e sur \u00ab absolue \u00bb : le fonctionnement est identique aux pacemakers plus anciens et l\u2019\u00e9v\u00e8nement n\u2019appara\u00eet pas sur la chaine de marqueur.<\/p><p>Si la m\u00e9thode BAPV est programm\u00e9e sur \u00ab partielle \u00bb : un \u00e9v\u00e9nement atrial survenant dans cette p\u00e9riode appara\u00eet sur le chaine de marquer et est \u00e9tiquet\u00e9 Ab. Cet \u00e9v\u00e8nement atrial ne d\u00e9clenche pas de d\u00e9lai AV mais est comptabilis\u00e9 pour le diagnostic d\u2019arythmie atriale. La sensibilit\u00e9 atriale n\u2019est pas modifi\u00e9e.<\/p><p>Si la m\u00e9thode BAPV est programm\u00e9e sur \u00ab partielle + \u00bb, le fonctionnement est identique au pr\u00e9c\u00e9dent si ce n\u2019est qu\u2019apr\u00e8s un \u00e9v\u00e9nement ventriculaire d\u00e9tect\u00e9 ou stimul\u00e9, le seuil de d\u00e9tection atriale augmente et le dispositif devient moins sensible (pour \u00e9viter l'\u00e9coute crois\u00e9e).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-436fcab elementor-widget elementor-widget-image\" data-id=\"436fcab\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_12.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_12\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5MywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzEyLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"491\" height=\"282\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_12.png\" class=\"attachment-large size-large wp-image-6793\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_12.png 491w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_12-300x172.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_12-18x10.png 18w\" sizes=\"(max-width: 491px) 100vw, 491px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-891d40f elementor-widget elementor-widget-text-editor\" data-id=\"891d40f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">La p\u00e9riode r\u00e9fractaire atriale post-ventriculaire (PRAPV)<\/span><\/p><p>La PRAPV peut \u00eatre programm\u00e9e sur une valeur fixe ou sur automatique. Lorsque la PRAPV automatique est programm\u00e9e, le stimulateur d\u00e9termine une valeur pour la PRAPV en fonction de la fr\u00e9quence atriale moyenne. La PRAPV automatique est destin\u00e9e \u00e0 augmenter la fr\u00e9quence du bloc 2:1 en raccourcissant la PRAPV et le d\u00e9lai AV d\u00e9tect\u00e9 (le cas \u00e9ch\u00e9ant) \u00e0 des fr\u00e9quences de suivi plus \u00e9lev\u00e9es et \u00e0 offrir une protection contre les TRE \u00e0 des fr\u00e9quences minimales avec une PRAPV plus longue.<\/p><p>La valeur de param\u00e8tre PRAPV minimale programmable d\u00e9finit une limite sur la PRAPV la plus courte autoris\u00e9e.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ea949c elementor-widget elementor-widget-image\" data-id=\"3ea949c\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_13.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_13\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc5MiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzEzLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"495\" height=\"307\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_13.png\" class=\"attachment-large size-large wp-image-6792\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_13.png 495w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_13-300x186.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_13-18x12.png 18w\" sizes=\"(max-width: 495px) 100vw, 495px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d654790 elementor-widget elementor-widget-heading\" data-id=\"d654790\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Microport<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-58178ad elementor-widget elementor-widget-text-editor\" data-id=\"58178ad\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Le blanking atrial post-ventriculaire<\/span><\/p><p>Suite \u00e0 une stimulation ventriculaire, une p\u00e9riode r\u00e9fractaire absolue de 150 ms (valeur nominale) est d\u00e9clench\u00e9e \u00e0 l\u2019\u00e9tage atrial. Les 100 premi\u00e8res ms sont une p\u00e9riode r\u00e9fractaire absolue et les 50 ms suivantes sont red\u00e9clenchables automatiquement.<\/p><p>Suite \u00e0 une d\u00e9tection ventriculaire, une p\u00e9riode r\u00e9fractaire absolue de 100  ms (valeur nominale) est d\u00e9clench\u00e9e \u00e0 l\u2019\u00e9tage atrial. Les 50 premi\u00e8res ms sont une p\u00e9riode r\u00e9fractaire absolue et les 50 ms suivantes sont red\u00e9clenchables automatiquement.<\/p><p>Quand l\u2019utilisateur modifie la valeur du BAPV (post stimulation), il modifie aussi le BAPV post d\u00e9tection.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b8b4f43 elementor-widget elementor-widget-image\" data-id=\"b8b4f43\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_16.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_16\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc4OSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzE2LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"510\" height=\"583\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_16.png\" class=\"attachment-large size-large wp-image-6789\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_16.png 510w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_16-262x300.png 262w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_16-10x12.png 10w\" sizes=\"(max-width: 510px) 100vw, 510px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c41f338 elementor-widget elementor-widget-text-editor\" data-id=\"c41f338\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">La p\u00e9riode r\u00e9fractaire atriale post-ventriculaire (PRAPV)<\/span><\/p><p>Les stimulateurs Sorin CRM-Microport pr\u00e9sentent certaines sp\u00e9cificit\u00e9s en termes de p\u00e9riodes r\u00e9fractaires atriales. En effet, il n'y a pas \u00e0 proprement parler de PRAPV qui est remplac\u00e9e par :<\/p><ul><li>la fen\u00eatre de DARA : suite \u00e0 un \u00e9v\u00e8nement atrial, une p\u00e9riode r\u00e9fractaire relative est d\u00e9clench\u00e9e \u00e0 l\u2019\u00e9tage atrial. Sa dur\u00e9e est dynamique et est calcul\u00e9e en fonction du rythme atrial. Elle a pour but principal de D\u00e9tecter l\u2019Acc\u00e9l\u00e9ration du Rythme Atrial (d\u2019o\u00f9 son nom : fen\u00eatre de DARA). La deuxi\u00e8me fonctionnalit\u00e9 de la fen\u00eatre de DARA est de ne pas d\u00e9clencher de d\u00e9lai AV sur des d\u00e9tections atriales trop proches d\u2019un \u00e9v\u00e8nement ventriculaire. Le fonctionnement, avec le calcul dynamique de la dur\u00e9e de la fen\u00eatre de DARA est expliqu\u00e9 dans le chapitre sur la gestion des arythmies atriales<\/li><li>la RetroPwatch : suite \u00e0 une d\u00e9tection ventriculaire consid\u00e9r\u00e9e comme ESV une p\u00e9riode r\u00e9fractaire relative est d\u00e9clench\u00e9e \u00e0 l\u2019\u00e9tage atrial. Sa dur\u00e9e est de 500 ms.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ca043fd elementor-widget elementor-widget-image\" data-id=\"ca043fd\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_17.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_periodes_refractaires_17\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Njc4OCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfcGVyaW9kZXNfcmVmcmFjdGFpcmVzXzE3LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"683\" height=\"418\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_17.png\" class=\"attachment-large size-large wp-image-6788\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_17.png 683w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_17-300x184.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_periodes_refractaires_17-18x12.png 18w\" sizes=\"(max-width: 683px) 100vw, 683px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Atrial refractory periods Content General information Blanking and the post-atrial atrial refractory period Atrial blanking and the atrial refractory period (ARP) occur following stimulated or detected atrial events. Post-ventricular atrial refractory period Post-ventricular atrial blanking (PVAB) This is an absolute refractory period applied in the atrium after ventricular detection and stimulation. Any ventricular event detected [&hellip;]<\/p>","protected":false},"author":1,"featured_media":0,"parent":21,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-284","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pacemaker Atrial Refractory Periods: PVARP, PVAB, ARP | Cardiocases<\/title>\n<meta name=\"description\" content=\"Master pacemaker atrial refractory periods \u2014 PVARP, PVAB, ARP explained with real ECG tracings. Avoid PMT, crosstalk &amp; oversensing. 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