{"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":"\t\t<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-e-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-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Flutter management<\/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-e-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-e-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\tContent\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-e-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-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">General information<\/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-e-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-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>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.<\/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-e-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-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Brand specific information<\/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-e-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-e-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-e-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-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>No such algorithm; when a 2\/1 flutter occurs, it is necessary to shorten the duration of atrial blanking post ventricular pacing.<\/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-e-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-e-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-e-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-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>2:1 lock in protection algorithm<\/h6><p>An algorithm (protection 2:1 lock in) has been developed to detect under-detection of masked flutter with absence of folding, as every second atrial activity falls within the far-field atrial protection after ventricular pacing.<\/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-e-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-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>When the device detects 8 consecutive atrial events in the atrial far-field window, and the stimulated ventricular rate is greater than 100 bpm, it suspects 2\/1 masked flutter and lengthens the AV delay to a maximum value of 300 ms over one cycle. If the atrial cycle is lengthened, the device concludes that there is cross-hearing and does not switch; on the other hand, if the atrial cycles are not modified by the change in AV delay, it concludes that there is atrial flutter and switches.<\/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-e-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-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Operation of the 2:1 lock-in protection algorithm: 8 consecutive cycles with alternating As and Ars (FFP); lengthening of the AV delay; the second cycle becomes Ars without modification of the duration of the atrial cycles; flutter diagnosis and mode switching;<\/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-e-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-e-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-e-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-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Response to atrial flutter (RAF)<\/h6><p>The objectives of this algorithm are to prevent pacing in a vulnerable atrial period (by inhibiting all atrial pacing until the RAF windows have ended) and to ensure immediate fallback in the event of atrial events exceeding the programmable RAF frequency. This fallback is maintained as long as atrial events continue to exceed the RAF frequency.<\/p><p>In atrial flutter, an atrial signal detected in the PVARP triggers an RAF window (if RAF programmed at 230 min-1, RAF window of 260 ms); if an atrial signal is detected within this window, it triggers a new window (classified as AS in refractory period).<\/p><p>Ventricular pacing is unaffected by RAF, and occurs as expected (minimum frequency or sensor frequency).<\/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-e-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-e-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-e-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-e-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-e-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-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Masked flutter detection algorithm<\/h6><p>This algorithm looks for the presence of an unseen atrial signal falling into atrial blanking post ventricular pacing when:<\/p><ul><li>there is a succession of rapid AS-VP cycles<\/li><li>there are 8 consecutive AS-AS intervals which are less than 2 times the sum of AV delay + atrial blanking post ventricular stimulation and less than 2 times the interval corresponding to the frequency of detection of an atrial arrhythmia.<\/li><\/ul><p>In this case, at the 9th cycle, the algorithm increases the PRAPV so that the next atrial event (AR) appears in the refractory period, the ventricle is not stimulated over a beat and the next flutter wave (AS) is unmasked and no longer hidden in the post-stimulation atrial blanking.<\/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-e-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-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>This algorithm was present on older pacemaker platforms, where post-ventricular atrial blanking was absolute. It should be remembered that on the new platforms, post-ventricular atrial blanking is no longer absolute (when the PVAB method is set to partial or partial +), and that a signal falling into blanking is counted for arrhythmia diagnosis, which limits the interest of this type of algorithm.<\/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-e-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-e-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-e-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-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>No such algorithm; when a 2\/1 flutter occurs, it is necessary to shorten the duration of atrial blanking post ventricular pacing.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","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>\n","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 v28.0 - 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\" 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