{"id":327,"date":"2025-07-14T14:16:21","date_gmt":"2025-07-14T14:16:21","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=327"},"modified":"2026-01-06T20:46:18","modified_gmt":"2026-01-06T20:46:18","slug":"pacemaker-mediated-tachycardia","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/basic-concepts\/pacemaker\/pacemaker-mediated-tachycardia\/","title":{"rendered":"La tachycardie r\u00e9entrante \u00e9lectronique (TRE)"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"327\" class=\"elementor elementor-327\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8d7133b e-con-full e-flex e-con e-parent\" data-id=\"8d7133b\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7aac51f elementor-widget elementor-widget-heading\" data-id=\"7aac51f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">La tachycardie r\u00e9entrante \u00e9lectronique (TRE)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5ffbe05 e-con-full e-flex e-con e-parent\" data-id=\"5ffbe05\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cffe8a2 elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"cffe8a2\" data-element_type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h3&quot;,&quot;h4&quot;,&quot;h5&quot;,&quot;h6&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__cffe8a2\" 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__cffe8a2\" 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__cffe8a2\" 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-7449f0d e-con-full e-flex e-con e-parent\" data-id=\"7449f0d\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7ae8b31 elementor-widget elementor-widget-heading\" data-id=\"7ae8b31\" 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-db8708a e-con-full e-flex e-con e-parent\" data-id=\"db8708a\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e7f2be5 elementor-widget elementor-widget-text-editor\" data-id=\"e7f2be5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>D\u00e9marrage, entretien et fr\u00e9quence d'une TRE<\/h6><p>Le d\u00e9marrage d'un PMT implique :<\/p><ul><li>la programmation d'un mode de suivi atrial (DDD ou VDD)<\/li><li>la perm\u00e9abilit\u00e9 de la conduction r\u00e9trograde<\/li><li>une perte momentan\u00e9e ou permanente de la synchronisation atrio-ventriculaire. En effet, si l\u2019activit\u00e9 ventriculaire est correctement synchronis\u00e9e \u00e0 celle de l\u2019oreillette, la conduction r\u00e9trograde est bloqu\u00e9e.<\/li><\/ul><p>La conduction r\u00e9trograde est pr\u00e9sente en moyenne chez 40% des patients stimul\u00e9s au repos, toutes indications confondues. Elle est beaucoup plus fr\u00e9quente chez les patients implant\u00e9s pour dysfonction sinusale (jusqu\u2019\u00e0 80%) que pour bloc auriculo-ventriculaire.<\/p><p>A l\u2019effort, l\u2019incidence moyenne atteint 75%. Ces chiffres sont suffisamment \u00e9lev\u00e9s pour justifier d\u2019une protection efficace \u00e0 programmer syst\u00e9matiquement.<\/p><p>Les \u00e9v\u00e9nements suivants peuvent favoriser une dissociation AV, une conduction r\u00e9trograde et le d\u00e9clenchement d'une TRE:<\/p><ul><li>une extrasystole ventriculaire (cause la plus fr\u00e9quente) ;<br \/>une extrasystole atriale avec allongement du d\u00e9lai AV pour respecter la fr\u00e9quence cardiaque maximale programm\u00e9e ;<\/li><li>fr\u00e9quence cardiaque maximale programm\u00e9e ;<br \/>un d\u00e9lai AV programm\u00e9 trop long (la voie nodo-hissienne est sortie de sa p\u00e9riode r\u00e9fractaire au moment de la stimulation ventriculaire) ;<\/li><li>stimulation ventriculaire) ;<br \/>une interf\u00e9rence externe ou des myopotentiels d\u00e9tect\u00e9s par la chaine atriale ;<\/li><li>un d\u00e9faut de d\u00e9tection ou de stimulation atriale ;<\/li><li>une absence d\u2019extension de PRAPV apr\u00e8s retrait d\u2019un aimant, ou sortie de repli lors de la r\u00e9association AV 1\/1 ;<\/li><li>application et retrait d\u2019un aimant ;<\/li><li>programmation du mode VDD chez un patient avec rythme sinusal plus lent que la fr\u00e9quence minimale programm\u00e9e ;<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-896e094 elementor-widget elementor-widget-image\" data-id=\"896e094\" 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_tre_1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_tre_1\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjczNiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfdHJlXzEucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"729\" height=\"994\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_1.png\" class=\"attachment-large size-large wp-image-6736\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_1.png 729w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_1-220x300.png 220w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_1-9x12.png 9w\" sizes=\"(max-width: 729px) 100vw, 729px\" \/>\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-8f75b47 elementor-widget elementor-widget-text-editor\" data-id=\"8f75b47\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>L\u2019entretien de la TRE r\u00e9sulte de la d\u00e9tection hors p\u00e9riodes r\u00e9fractaires d\u2019une onde P' r\u00e9trograde qui entraine le d\u00e9clenchement d'un d\u00e9lai AV souvent allong\u00e9, qui favorise de nouveau la conduction r\u00e9trograde apr\u00e8s stimulation ventriculaire. Une TRE est donc une s\u00e9quence r\u00e9p\u00e9titive dans laquelle le stimulateur r\u00e9agit \u00e0 chaque onde P' r\u00e9trograde en stimulant le ventricule \u00e0 une fr\u00e9quence \u00e9lev\u00e9e qui \u00e0 son tour g\u00e9n\u00e8re une onde P' r\u00e9trograde.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f4d0df7 elementor-widget elementor-widget-image\" data-id=\"f4d0df7\" 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_tre_2.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_tre_2\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjczNSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfdHJlXzIucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"690\" height=\"377\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_2.png\" class=\"attachment-large size-large wp-image-6735\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_2.png 690w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_2-300x164.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_2-18x10.png 18w\" sizes=\"(max-width: 690px) 100vw, 690px\" \/>\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-a726322 elementor-widget elementor-widget-text-editor\" data-id=\"a726322\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Le cycle se r\u00e9p\u00e8te ainsi ind\u00e9finiment \u00e0 moins de l'apparition d'un bloc r\u00e9trograde ou de l'intervention d'un algorithme sp\u00e9cifique du stimulateur.<\/p><p>Une TRE de dur\u00e9e prolong\u00e9e peut \u00eatre mal support\u00e9e avec une symptomatologie allant de la simple sensation de mal \u00eatre ou de palpitations jusqu'\u00e0 la d\u00e9compensation cardiaque chez les patients pr\u00e9sentant une cardiopathie sous-jacente.<\/p><p>La fr\u00e9quence cardiaque durant une TRE d\u00e9pend :<\/p><ul><li>du temps de conduction r\u00e9trograde<\/li><li>de la fr\u00e9quence maximale programm\u00e9e<\/li><li>du d\u00e9lai AV en cours<\/li><\/ul><p>Si la somme temps de conduction r\u00e9trograde + d\u00e9lai AV (\u00e0 la fr\u00e9quence maximale) est plus courte que l\u2019intervalle minimal de stimulation (60000\/fr\u00e9quence maximale), la fr\u00e9quence de la TRE est \u00e9gale \u00e0 la fr\u00e9quence maximale programm\u00e9e, le d\u00e9lai AV est stable et allong\u00e9 \u00e0 chaque cycle..<\/p><p>Si la somme temps de conduction r\u00e9trograde + d\u00e9lai AV (\u00e0 la fr\u00e9quence de la TRE) est plus longue que l\u2019intervalle minimal de stimulation (60000\/fr\u00e9quence maximale), la fr\u00e9quence de la TRE est inf\u00e9rieure \u00e0 la fr\u00e9quence maximale et \u00e9gale \u00e0 60000\/(TCR + d\u00e9lai AV), et le d\u00e9lai AV est celui programm\u00e9 \u00e0 la fr\u00e9quence en cours. Ce cas de figure est observ\u00e9 dans environ 35% des cas.<\/p><h6>La pr\u00e9vention du d\u00e9marrage des TRE<\/h6><p>Diff\u00e9rentes options compl\u00e9mentaires peuvent \u00eatre privil\u00e9gi\u00e9es pour pr\u00e9venir la survenue des TRE:<\/p><ul><li>la programmation d'un mode sans suivi atrial comme le DDI qui permet d'\u00e9viter la survenue des TRE. Ce mode de stimulation pr\u00e9sente toutefois des limites incompatibles avec les caract\u00e9ristiques de certains patients (pas de suivi des ondes P d\u00e9tect\u00e9es).<\/li><li>la programmation d'une PRAPV plus longue que le temps de conduction r\u00e9trograde qui peut \u00eatre mesur\u00e9 au moment de l'implantation. Il faut rappeler toutefois que la programmation d'une PRAPV trop longue peut induire l\u2019apparition d\u2019un bloc 2:1 \u00e0 l'effort mal support\u00e9 par le patient. La programmation d\u2019une PVARP et\/ou d\u2019un d\u00e9lai AV adaptables permet d\u2019augmenter la capacit\u00e9 d\u2019effort. Une PRAPV programm\u00e9e \u00e0 300 ms est suffisante chez la majorit\u00e9 des patients pour \u00e9viter la survenue d'une TRE.<\/li><li>\u00e9viter toute situation favorisant une perte de synchronisme AV :<\/li><li>programmer des d\u00e9lais AV courts plut\u00f4t que longs<\/li><li>assurer une d\u00e9tection et une stimulation correctes et permanentes (marge suffisante)<\/li><li>programmer une d\u00e9tection atriale bipolaire pour \u00e9viter la d\u00e9tection de myopotentiels ou d'interf\u00e9rences ext\u00e9rieures<br \/>extension automatique du PVARP lors du retrait de l'aimant, sortie d'inversion du bruit, sortie de repli, programmation des param\u00e8tres<\/li><li>allonger automatiquement la PRAPV apr\u00e8s une ESV : l\u2019objectif est d\u2019emp\u00eacher le suivi d\u2019ondes P' r\u00e9trogrades (ou de l'activit\u00e9 sinusale) engendr\u00e9es par les extrasystoles ventriculaires.<\/li><li>La conduction r\u00e9trograde suivant une ESV peut perturber le synchronisme AV et affecter la synchronisation du mode de stimulation. Le stimulateur d\u00e9finit une ESV comme tout \u00e9v\u00e9nement ventriculaire d\u00e9tect\u00e9 qui suit un autre \u00e9v\u00e9nement ventriculaire stimul\u00e9, r\u00e9fractaire ou d\u00e9tect\u00e9 sans qu\u2019il y ait un \u00e9v\u00e9nement atrial interm\u00e9diaire.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5837ab3 elementor-widget elementor-widget-image\" data-id=\"5837ab3\" 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_tre_3.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_tre_3\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjczNCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfdHJlXzMucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"714\" height=\"338\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_3.png\" class=\"attachment-large size-large wp-image-6734\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_3.png 714w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_3-300x142.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_3-18x9.png 18w\" sizes=\"(max-width: 714px) 100vw, 714px\" \/>\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-62c7327 elementor-widget elementor-widget-text-editor\" data-id=\"62c7327\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Diagnostic d'une TRE par le stimulateur<\/h6>\n<p>Le mode de diagnostic d\u2019une TRE varie en fonction des diff\u00e9rentes compagnies mais est bas\u00e9 sur la r\u00e9p\u00e9tition sur plusieurs cycles d\u2019une d\u00e9tection atriale et d\u2019une stimulation ventriculaire avec une fr\u00e9quence \u00e9lev\u00e9e et un couplage VP-AS fixe.<\/p>\n<h6>Intervention anti-TRE<\/h6>\n<p><span style=\"font-size: 1rem;\">PMT<\/span><span style=\"font-size: 1rem;\">&nbsp;<\/span>Les algorithmes d\u2019interruption des TRE varient en fonction des constructeurs. Le plus souvent, une fois le diagnostic de TRE suspect\u00e9, le stimulateur allonge temporairement la PRAPV pour que l'\u00e9v\u00e9nement atrial suivant soit d\u00e9tect\u00e9 dans la p\u00e9riode r\u00e9fractaire. Cet \u00e9v\u00e9nement r\u00e9fractaire n'est pas synchronis\u00e9 au ventricule pendant 1 cycle et la tachycardie est interrompue.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d5cd647 elementor-widget elementor-widget-image\" data-id=\"d5cd647\" 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_tre_4.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_tre_4\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjczMywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfdHJlXzQucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"520\" height=\"274\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_4.png\" class=\"attachment-large size-large wp-image-6733\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_4.png 520w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_4-300x158.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_tre_4-18x9.png 18w\" sizes=\"(max-width: 520px) 100vw, 520px\" \/>\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>Pacemaker mediated tachycardia Content General information Starting, maintaining and frequency of an PMT Starting an PMT involves : programming an atrial monitoring mode (DDD or VDD) permeability of retrograde conduction momentary or permanent loss of atrio-ventricular synchronization. If ventricular activity is correctly synchronized with atrial activity, retrograde conduction is blocked. Retrograde conduction is present in [&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-327","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 Mediated Tachycardia (PMT) | Cardiocases<\/title>\n<meta name=\"description\" content=\"Pacemaker mediated tachycardia (PMT) \u2014 causes, ECG recognition, prevention programming &amp; real device tracings.\" \/>\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\/pacemaker-mediated-tachycardia\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" 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