{"id":308,"date":"2025-07-13T10:12:15","date_gmt":"2025-07-13T10:12:15","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=308"},"modified":"2026-01-06T20:25:30","modified_gmt":"2026-01-06T20:25:30","slug":"flutter-management","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/basic-concepts\/pacemaker\/flutter-management\/","title":{"rendered":"Gestion du flutter"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"308\" class=\"elementor elementor-308\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1aa7788 e-con-full e-flex e-con e-parent\" data-id=\"1aa7788\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e2d241b elementor-widget elementor-widget-heading\" data-id=\"e2d241b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Gestion du flutter<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-516b3d2 e-con-full e-flex e-con e-parent\" data-id=\"516b3d2\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f67b14a elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"f67b14a\" 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__f67b14a\" 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__f67b14a\" 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__f67b14a\" 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-c518cd8 e-con-full e-flex e-con e-parent\" data-id=\"c518cd8\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6287513 elementor-widget elementor-widget-heading\" data-id=\"6287513\" 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-66ffd10 e-con-full e-flex e-con e-parent\" data-id=\"66ffd10\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-969dbbb elementor-widget elementor-widget-text-editor\" data-id=\"969dbbb\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Il peut exister en fonction des constructeurs et des dispositifs, un algorithme sp\u00e9cifique permettant de rechercher la pr\u00e9sence d'un flutter 2\/1 (2 activit\u00e9s atriales pour une stimulation ventriculaire) qui peut entrainer une stimulation ventriculaire rapide, un signal atrial sur deux tombant dans le blanking atrial post ventriculaire.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-aac8f22 e-con-full e-flex e-con e-parent\" data-id=\"aac8f22\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e2e7be1 elementor-widget elementor-widget-heading\" data-id=\"e2e7be1\" 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>\n\t\t<div class=\"elementor-element elementor-element-594a9ff e-con-full e-flex e-con e-parent\" data-id=\"594a9ff\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-da09b7b elementor-widget elementor-widget-heading\" data-id=\"da09b7b\" 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>\n\t\t<div class=\"elementor-element elementor-element-b3c8b66 e-flex e-con-boxed e-con e-parent\" data-id=\"b3c8b66\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d24a458 elementor-widget elementor-widget-text-editor\" data-id=\"d24a458\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Pas d\u2019algorithme de ce type ; quand un flutter 2\/1 survient, il est n\u00e9cessaire de raccourcir la dur\u00e9e du blanking atrial post-stimulation ventriculaire.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5170984 e-con-full e-flex e-con e-parent\" data-id=\"5170984\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d52a20a elementor-widget elementor-widget-heading\" data-id=\"d52a20a\" 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>\n\t\t<div class=\"elementor-element elementor-element-bf887d7 e-con-full e-flex e-con e-parent\" data-id=\"bf887d7\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4e700be elementor-widget elementor-widget-text-editor\" data-id=\"4e700be\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>algorithme protection 2:1 lock in<\/h6><p>Il existe un algorithme (protection 2:1 lock in) qui a pour objectif de rechercher l\u2019existence d\u2019une sous-d\u00e9tection d\u2019un flutter masqu\u00e9 avec absence de repli car une activit\u00e9 atriale sur deux tombe dans la protection atriale far-field post stimulation ventriculaire.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8c0c6ba elementor-widget elementor-widget-image\" data-id=\"8c0c6ba\" 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_arythmies_f1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_f1\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjY5OCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2YxLnBuZyJ9\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"573\" height=\"224\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f1.png\" class=\"attachment-large size-large wp-image-6698\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f1.png 573w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f1-300x117.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f1-18x7.png 18w\" sizes=\"(max-width: 573px) 100vw, 573px\" \/>\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-df5c959 elementor-widget elementor-widget-text-editor\" data-id=\"df5c959\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Quand le dispositif d\u00e9tecte 8 \u00e9v\u00e8nements atriaux cons\u00e9cutifs dans la fen\u00eatre far-field atriale, et que le rythme ventriculaire stimul\u00e9 est sup\u00e9rieur \u00e0 100 bpm, il suspecte l\u2019existence d\u2019un flutter masqu\u00e9 2\/1 et allonge le d\u00e9lai AV \u00e0 une valeur maximale de 300 ms sur un cycle. Si le cycle atrial s\u2019allonge, le dispositif conclut \u00e0 une \u00e9coute crois\u00e9e et ne commute pas ; en revanche, si les cycles atriaux ne sont pas modifi\u00e9s par le changement de d\u00e9lai AV, il conclut \u00e0 un flutter atrial et commute.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-34f521d elementor-widget elementor-widget-image\" data-id=\"34f521d\" 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_arythmies_f2.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_f2\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjY5NywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2YyLnBuZyJ9\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"578\" height=\"349\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f2.png\" class=\"attachment-large size-large wp-image-6697\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f2.png 578w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f2-300x181.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f2-18x12.png 18w\" sizes=\"(max-width: 578px) 100vw, 578px\" \/>\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-a6d31df elementor-widget elementor-widget-text-editor\" data-id=\"a6d31df\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Fonctionnement de l\u2019algorithme protection 2 :1 lock in : 8 cycles cons\u00e9cutifs avec alternance As et Ars (FFP) ; allongement du d\u00e9lai AV ; le second cycle devient Ars sans modification de la dur\u00e9e des cycles atriaux ; diagnostic de flutter et commutation de mode ;<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a9e49bc e-flex e-con-boxed e-con e-parent\" data-id=\"a9e49bc\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-65d9eb8 elementor-widget elementor-widget-heading\" data-id=\"65d9eb8\" 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\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ebb0e10 e-flex e-con-boxed e-con e-parent\" data-id=\"ebb0e10\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5e932fa elementor-widget elementor-widget-text-editor\" data-id=\"5e932fa\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>r\u00e9ponse au flutter atrial (RFA)<\/h6><p>Cet algorithme a pour objectifs de pr\u00e9venir la stimulation dans une p\u00e9riode vuln\u00e9rable atriale (en inhibant toute stimulation atriale tant que les fen\u00eatres AFR ne sont pas termin\u00e9es) et d'assurer un repli imm\u00e9diat en cas de fr\u00e9quence atriale sup\u00e9rieure \u00e0 la fr\u00e9quence programmable RFA. Ce repli se maintient tant que les \u00e9v\u00e8nements atriaux continuent de d\u00e9passer la fr\u00e9quence RFA.<\/p><p>Lors d'un flutter atrial, un signal atrial d\u00e9tect\u00e9 dans la PRAPV d\u00e9clenche une fen\u00eatre AFR (si RFA programm\u00e9e \u00e0 230 min-1, fen\u00eatre RFA de 260 ms); si un signal atrial est d\u00e9tect\u00e9 dans cette fen\u00eatre, il d\u00e9clenche une nouvelle fen\u00eatre (class\u00e9 AS en p\u00e9riode r\u00e9fractaire).<\/p><p>La stimulation ventriculaire n\u2019est pas affect\u00e9e par la RFA, elle survient comme pr\u00e9vue (fr\u00e9quence minimale ou fr\u00e9quence capteur).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-92b0cb3 elementor-widget elementor-widget-image\" data-id=\"92b0cb3\" 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_arythmies_f3.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_f3\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjY5NiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2YzLnBuZyJ9\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"364\" height=\"185\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f3.png\" class=\"attachment-large size-large wp-image-6696\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f3.png 364w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f3-300x152.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f3-18x9.png 18w\" sizes=\"(max-width: 364px) 100vw, 364px\" \/>\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-86b44dd elementor-widget elementor-widget-image\" data-id=\"86b44dd\" 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_arythmies_f4.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_f4\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjY5NSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2Y0LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"547\" height=\"458\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f4.png\" class=\"attachment-large size-large wp-image-6695\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f4.png 547w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f4-300x251.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f4-14x12.png 14w\" sizes=\"(max-width: 547px) 100vw, 547px\" \/>\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\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5c2c88c e-con-full e-flex e-con e-parent\" data-id=\"5c2c88c\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a56f986 elementor-widget elementor-widget-heading\" data-id=\"a56f986\" 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>\n\t\t<div class=\"elementor-element elementor-element-f467e13 e-con-full e-flex e-con e-parent\" data-id=\"f467e13\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a85a88f elementor-widget elementor-widget-text-editor\" data-id=\"a85a88f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>algorithme de d\u00e9tection du flutter masqu\u00e9<\/h6><p>Cet algorithme recherche la pr\u00e9sence d'un signal atrial non vu car tombant dans le blanking atrial post-stimulation ventriculaire quand:<\/p><ul><li>il y a une succession de cycles rapides AS-VP<\/li><li>il y a 8 intervalles AS-AS cons\u00e9cutifs qui sont inf\u00e9rieurs \u00e0 2 fois la somme d\u00e9lai AV + blanking atrial post-stimulation ventriculaire et inf\u00e9rieurs \u00e0 2 fois l'intervalle correspondant \u00e0 la fr\u00e9quence de d\u00e9tection d'une arythmie atriale.<\/li><\/ul><p>Dans ce cas, au 9\u00e8me cycle, l'algorithme augmente le PRAPV de sorte que l'\u00e9v\u00e9nement auriculaire suivant (AR) apparaisse dans la p\u00e9riode r\u00e9fractaire, que le ventricule ne soit pas stimul\u00e9 sur un battement et que l'onde de flutter suivante (AS) soit d\u00e9masqu\u00e9e et ne soit plus cach\u00e9e dans le blanking auriculaire post-stimulation.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e9df88b elementor-widget elementor-widget-image\" data-id=\"e9df88b\" 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_arythmies_f5.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_f5\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjY5NCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2Y1LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"739\" height=\"207\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f5.png\" class=\"attachment-large size-large wp-image-6694\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f5.png 739w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f5-300x84.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_f5-18x5.png 18w\" sizes=\"(max-width: 739px) 100vw, 739px\" \/>\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-f8901a9 elementor-widget elementor-widget-text-editor\" data-id=\"f8901a9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Cet algorithme \u00e9tait pr\u00e9sent sur les anciennes plates-formes de stimulateurs cardiaques, o\u00f9 la suppression atriale post-ventriculaire \u00e9tait absolue. Il faut rappeler que sur les nouvelles plateformes, le blanking atrial post-ventriculaire n'est plus absolu (lorsque la m\u00e9thode PVAB est r\u00e9gl\u00e9e sur partiel ou partiel +), et qu'un signal tombant dans le blanking est comptabilis\u00e9 pour le diagnostic d'arythmie, ce qui limite l'int\u00e9r\u00eat de ce type d'algorithme.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-eeb438c e-con-full e-flex e-con e-parent\" data-id=\"eeb438c\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ec96fd7 elementor-widget elementor-widget-heading\" data-id=\"ec96fd7\" 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>\n\t\t<div class=\"elementor-element elementor-element-d3e0bb0 e-con-full e-flex e-con e-parent\" data-id=\"d3e0bb0\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-39ba44a elementor-widget elementor-widget-text-editor\" data-id=\"39ba44a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Pas d\u2019algorithme de ce type ; quand un flutter 2\/1 survient, il est n\u00e9cessaire de raccourcir la dur\u00e9e du blanking atrial post-stimulation ventriculaire.<\/p>\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>Flutter management Content General information Depending on the manufacturer and device, there may be a specific algorithm to search for the presence of 2\/1 flutter (2 atrial activities for one ventricular stimulation), which can lead to rapid ventricular pacing, with one out of every two atrial signals falling into post ventricular atrial blanking. Brand specific [&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-308","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 Flutter Management | ECG | Cardiocases<\/title>\n<meta name=\"description\" content=\"Pacemaker management of atrial flutter \u2014 tracking, mode switch, antitachycardia pacing &amp; ECG recognition.\" \/>\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\/pacing-defibrillation\/basic-concepts\/pacemaker\/flutter-management\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pacemaker Flutter Management | ECG | Cardiocases\" \/>\n<meta property=\"og:description\" content=\"Pacemaker management of atrial flutter \u2014 tracking, mode switch, antitachycardia pacing &amp; 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