{"id":3530,"date":"2025-10-08T18:17:42","date_gmt":"2025-10-08T18:17:42","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=3530"},"modified":"2026-01-02T10:08:02","modified_gmt":"2026-01-02T10:08:02","slug":"av-delay-pmt-refractory-periods-biotronik","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/biotronik\/av-delay-pmt-refractory-periods-biotronik\/","title":{"rendered":"D\u00e9lai AV, TRE, p\u00e9riodes r\u00e9fractaires"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"3530\" class=\"elementor elementor-3530\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-af91c5e e-con-full e-flex e-con e-parent\" data-id=\"af91c5e\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1e00a1e elementor-widget elementor-widget-heading\" data-id=\"1e00a1e\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Biotronik - Retard AV, PMT, p\u00e9riodes r\u00e9fractaires<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e0f242a elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"e0f242a\" 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__e0f242a\" 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__e0f242a\" 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__e0f242a\" 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 class=\"elementor-element elementor-element-1a219fc elementor-widget elementor-widget-heading\" data-id=\"1a219fc\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Les p\u00e9riodes r\u00e9fractaires atriales<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-90e9293 elementor-widget elementor-widget-text-editor\" data-id=\"90e9293\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>P\u00e9riode r\u00e9fractaire auriculaire<\/strong><\/p><ul><li>la p\u00e9riode r\u00e9fractaire auriculaire est r\u00e9gl\u00e9e par d\u00e9faut sur AUTO<\/li><li>cela signifie que la p\u00e9riode r\u00e9fractaire auriculaire est \u00e9gale \u00e0 225 ms ; si le d\u00e9lai AV est programm\u00e9 pour une dur\u00e9e sup\u00e9rieure \u00e0 225 ms, la p\u00e9riode r\u00e9fractaire auriculaire est prolong\u00e9e pour correspondre \u00e0 la valeur du d\u00e9lai AV<\/li><\/ul><p><strong>\u00a0<\/strong><\/p><p><strong>Protection en champ lointain<\/strong><\/p><ul><li>les \u00e9v\u00e9nements d\u00e9tect\u00e9s au cours de cette temporisation sont annot\u00e9s comme des \u00e9v\u00e9nements Ars (FFP) mais ne sont pas pris en compte pour le changement de mode.<\/li><li>la r\u00e9solution de programmation pour la protection en champ lointain est de 100 ms \u00e0 220 ms apr\u00e8s un \u00e9v\u00e9nement Vs, et de 100 ms \u00e0 220 ms apr\u00e8s un \u00e9v\u00e9nement Vp<\/li><\/ul><p><strong>\u00a0<\/strong><\/p><p><strong>PVARP<\/strong><\/p><ul><li>il y a un PVARP apr\u00e8s VP et un PVC mais pas apr\u00e8s un cycle class\u00e9 VS<\/li><li>le PVARP peut \u00eatre programm\u00e9 sur Auto ou sur une valeur fixe<\/li><li>apr\u00e8s un PVC, le PVARP est automatiquement prolong\u00e9 jusqu'\u00e0 PVARP + 150 ms, jusqu'\u00e0 un maximum de 600 ms.<\/li><li>si la fonction PVARP est r\u00e9gl\u00e9e sur AUTO, la valeur de la PVARP est fix\u00e9e \u00e0 225 ms et celle de la PVARP apr\u00e8s PVC \u00e0 375 ms ; lorsqu'une tachycardie m\u00e9di\u00e9e par un stimulateur cardiaque est d\u00e9tect\u00e9e, l'algorithme prolonge automatiquement la PVARP et la PVARP apr\u00e8s PVC de 50 ms, jusqu'\u00e0 une valeur maximale de 600 ms.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ff0ee76 elementor-widget elementor-widget-image\" data-id=\"ff0ee76\" 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\/biotronic1a.jpg\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"biotronic0\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjUwMiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL2Jpb3Ryb25pYzFhLmpwZyJ9\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"606\" height=\"95\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1a.jpg\" class=\"attachment-large size-large wp-image-6502\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1a.jpg 606w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1a-300x47.jpg 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1a-18x3.jpg 18w\" sizes=\"(max-width: 606px) 100vw, 606px\" \/>\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-51d3ef5 elementor-widget elementor-widget-heading\" data-id=\"51d3ef5\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Retard AV<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-144fb8b elementor-widget elementor-widget-text-editor\" data-id=\"144fb8b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Le d\u00e9lai AV d\u00e9finit l'intervalle entre un \u00e9v\u00e9nement auriculaire stimul\u00e9 ou d\u00e9tect\u00e9 et l'impulsion de stimulation ventriculaire. Si le stimulateur est programm\u00e9 en mode de d\u00e9tection double chambre, un \u00e9v\u00e9nement ventriculaire intrins\u00e8que tombant dans le d\u00e9lai AV inhibe l'impulsion de stimulation ventriculaire.<\/p><ul><li>le d\u00e9lai AV apr\u00e8s les \u00e9v\u00e9nements de rythme auriculaire peut \u00eatre diff\u00e9renci\u00e9 de l'intervalle AV apr\u00e8s les \u00e9v\u00e9nements de sens auriculaire<\/li><li>la compensation de d\u00e9tection peut \u00eatre programm\u00e9e sur OFF et -10...(-5)...-120 ms ; lorsqu'elle est s\u00e9lectionn\u00e9e, le d\u00e9lai AV apr\u00e8s un \u00e9v\u00e9nement de d\u00e9tection auriculaire est le d\u00e9lai AV apr\u00e8s un rythme auriculaire moins la compensation de d\u00e9tection<\/li><li>les d\u00e9lais AV dynamiques peuvent \u00eatre programm\u00e9s individuellement pour chaque gamme de taux ou un d\u00e9lai AV fixe peut \u00eatre programm\u00e9 pour toutes les gammes<\/li><li>le d\u00e9lai AV dynamique permet une s\u00e9lection ind\u00e9pendante des d\u00e9lais AV \u00e0 partir de cinq gammes de taux \u00e0 des valeurs de d\u00e9lai AV pr\u00e9d\u00e9finies<\/li><\/ul><p>\u00a0<\/p><p><strong>Hyst\u00e9r\u00e9sis AV<\/strong><\/p><ul><li>OFF, Positif, N\u00e9gatif et I-Opt<\/li><li>Positif : hyst\u00e9r\u00e9sis - programmable 70, 110, 150 ou 200 ms de plus que le d\u00e9lai AV programm\u00e9<\/li><li>N\u00e9gatif : Hyst\u00e9r\u00e9sis - 10 ... (10) ... 150 ms<\/li><li>Cycles de r\u00e9p\u00e9tition\/balayage de l'AV : OFF, ON<\/li><\/ul><p>\u00a0<\/p><p><strong>Hyst\u00e9r\u00e9sis du d\u00e9lai AV positif<\/strong><\/p><ul><li>L'hyst\u00e9r\u00e9sis positive a \u00e9t\u00e9 con\u00e7ue pour promouvoir l'activit\u00e9 intrins\u00e8que en prolongeant p\u00e9riodiquement l'intervalle AV pour rechercher l'activit\u00e9 intrins\u00e8que.<\/li><li>en cas d'activit\u00e9 intrins\u00e8que, le d\u00e9lai AV maintient la valeur de l'hyst\u00e9r\u00e9sis pour favoriser les ondes R intrins\u00e8ques<\/li><li>la dur\u00e9e maximale de la temporisation AV est de 450 ms<\/li><li>elle sera automatiquement raccourcie \u00e0 mesure que la fr\u00e9quence augmente afin d'assurer une conduction AV appropri\u00e9e.<\/li><\/ul><p><strong>\u00a0<\/strong><\/p><p><strong>AV Hyst\u00e9r\u00e9sis r\u00e9p\u00e9titive<\/strong><\/p><p>Lorsque l'hyst\u00e9r\u00e9sis r\u00e9p\u00e9titive AV est activ\u00e9e, le d\u00e9lai AV est prolong\u00e9 d'une valeur d'hyst\u00e9r\u00e9sis d\u00e9finie apr\u00e8s avoir d\u00e9tect\u00e9 un \u00e9v\u00e9nement ventriculaire intrins\u00e8que.<\/p><ul><li>lorsqu'un \u00e9v\u00e9nement de stimulation ventriculaire se produit, un long d\u00e9lai AV est utilis\u00e9 pour le nombre de cycles programm\u00e9<\/li><li>si un rythme intrins\u00e8que se produit pendant l'un des cycles r\u00e9p\u00e9titifs, l'intervalle de retard AV de longue dur\u00e9e reste en vigueur<\/li><li>si un rythme intrins\u00e8que ne se produit pas pendant les cycles r\u00e9p\u00e9titifs, l'intervalle de retard AV d'origine reprend.<\/li><\/ul><p><strong>\u00a0<\/strong><\/p><p><strong>Hyst\u00e9r\u00e9sis du balayage AV<\/strong><\/p><ul><li>lorsque l'hyst\u00e9r\u00e9sis du balayage AV est activ\u00e9e, apr\u00e8s 180 cycles de stimulation cons\u00e9cutifs, le d\u00e9lai AV est prolong\u00e9 pour le nombre programm\u00e9 de cycles de stimulation<\/li><li>si un rythme intrins\u00e8que est d\u00e9tect\u00e9 pendant le d\u00e9lai AV prolong\u00e9, le d\u00e9lai AV le plus long reste en vigueur<\/li><li>si un rythme intrins\u00e8que n'est pas d\u00e9tect\u00e9 dans le nombre de cycles de balayage, la valeur initiale du d\u00e9lai AV reprend.<\/li><\/ul><p><strong><em>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I-Opt<\/em><\/strong><\/p><ul><li>I-Opt est une fonction \u00e0 bouton unique con\u00e7ue pour promouvoir l'activit\u00e9 intrins\u00e8que du ventricule.<\/li><\/ul><ul><li>lorsqu'elle est programm\u00e9e sur ON, l'hyst\u00e9r\u00e9sis AV est \u00e9tendue \u00e0 400 ms, quel que soit le d\u00e9lai AV programm\u00e9<\/li><li>lorsque la fr\u00e9quence cardiaque augmente, l'I-Opt se raccourcit pour assurer le maintien d'une conduction appropri\u00e9e<\/li><li>la combinaison d'un taux \u00e9lev\u00e9 et de I-Opt peut entra\u00eener une situation o\u00f9 un blocage 2:1 se produit pendant la fonction d'hyst\u00e9r\u00e9sis r\u00e9p\u00e9titive<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-54f799f elementor-widget elementor-widget-image\" data-id=\"54f799f\" 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\/biotronic1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"biotronic1\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjUwNCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL2Jpb3Ryb25pYzEucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"672\" height=\"439\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1.png\" class=\"attachment-large size-large wp-image-6504\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1.png 672w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1-300x196.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1-18x12.png 18w\" sizes=\"(max-width: 672px) 100vw, 672px\" \/>\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-035b438 elementor-widget elementor-widget-text-editor\" data-id=\"035b438\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Retard AV n\u00e9gatif Hyst\u00e9r\u00e9sis<\/strong><\/p><ul><li>avec hyst\u00e9r\u00e9sis n\u00e9gative du d\u00e9lai AV, le d\u00e9lai AV est r\u00e9duit d'une valeur d\u00e9finie apr\u00e8s la d\u00e9tection d'un \u00e9v\u00e9nement ventriculaire, ce qui favorise la stimulation ventriculaire<\/li><li>l'hyst\u00e9r\u00e9sis n\u00e9gative de la temporisation AV est limit\u00e9e \u00e0 une temporisation AV minimale de 10 ms<\/li><li>le d\u00e9lai AV normal reprend apr\u00e8s l'\u00e9coulement du nombre programm\u00e9 d'\u00e9v\u00e9nements cons\u00e9cutifs de stimulation ventriculaire (hyst\u00e9r\u00e9sis n\u00e9gative r\u00e9p\u00e9titive du d\u00e9lai AV)<\/li><\/ul><p><strong>AV Opt. Test<\/strong><\/p><p>Le test AV Opt. mesure la dur\u00e9e de l'onde P pour les \u00e9v\u00e9nements auriculaires stimul\u00e9s et d\u00e9tect\u00e9s et fournit des suggestions de programmation pour le d\u00e9lai AV stimul\u00e9s et d\u00e9tect\u00e9s. Ces suggestions visent \u00e0 \u00e9viter une stimulation ventriculaire pr\u00e9matur\u00e9e (troncature de l'onde A ; remplissage incomplet du VR) et excessivement retard\u00e9e (fusion des ondes E et A ; r\u00e9gurgitation mitrale) \u00e0 la suite d'\u00e9v\u00e9nements auriculaires intrins\u00e8ques et stimul\u00e9s.  AV. Le test ne peut pas \u00eatre effectu\u00e9 si la fr\u00e9quence cardiaque est sup\u00e9rieure \u00e0 100 bpm ou si le patient est en mode Switch.<\/p><ul><li>le test AV Opt. Le test peut \u00eatre initi\u00e9 par l'utilisateur dans le cadre d'un suivi de l'appareil.<\/li><li>cela d\u00e9clenche l'envoi d'IEGM de l'implant au programmateur, d'abord pendant le rythme intrins\u00e8que, puis pendant le rythme auriculaire.<\/li><li>le programmateur analyse les signaux IEGM et extrait la dur\u00e9e de l'onde P des diff\u00e9rentes s\u00e9quences<\/li><li>sur la base des dur\u00e9es d'ondes P mesur\u00e9es, le logiciel calcule la dur\u00e9e moyenne, ajoute 50 ms et affiche le r\u00e9sultat sous la forme d'un retard AV sugg\u00e9r\u00e9.<\/li><li>si aucune fr\u00e9quence auriculaire intrins\u00e8que n'est mesur\u00e9e ou si la fr\u00e9quence auriculaire stimul\u00e9e d\u00e9passe la limite sup\u00e9rieure, le programmateur utilise la compensation sensorielle programm\u00e9e pour calculer la suggestion de retard AV correspondante.<\/li><li>une fois la proc\u00e9dure de test termin\u00e9e, l'utilisateur a la possibilit\u00e9 de copier les param\u00e8tres sugg\u00e9r\u00e9s pour le d\u00e9lai AV sur l'\u00e9cran principal du programme en appuyant sur le bouton \u201cAccepter la suggestion\u201d.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3c56cc6 elementor-widget elementor-widget-image\" data-id=\"3c56cc6\" 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\/biotronic2.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"biotronic2\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjUwMywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL2Jpb3Ryb25pYzIucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"800\" height=\"460\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic2-1024x589.png\" class=\"attachment-large size-large wp-image-6503\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic2-1024x589.png 1024w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic2-300x172.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic2-768x441.png 768w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic2-18x10.png 18w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic2.png 1404w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\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-4ca32ec elementor-widget elementor-widget-heading\" data-id=\"4ca32ec\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Les p\u00e9riodes r\u00e9fractaires ventriculaires<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ab4ce1b elementor-widget elementor-widget-text-editor\" data-id=\"ab4ce1b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>P\u00e9riode r\u00e9fractaire ventriculaire<\/strong><\/p><ul><li>la p\u00e9riode r\u00e9fractaire du ventricule droit est appliqu\u00e9e \u00e0 tous les \u00e9v\u00e9nements ventriculaires (Vs, Vp et PVC)<\/li><li>ce param\u00e8tre est programmable de 200 \u00e0 500 ms<\/li><\/ul><p>\u00a0<\/p><p><strong>Blanchiment ventriculaire apr\u00e8s Ap<\/strong><\/p><ul><li>la suppression ventriculaire apr\u00e8s Ap est la p\u00e9riode qui suit une impulsion de stimulation auriculaire et pendant laquelle la d\u00e9tection ventriculaire est d\u00e9sactiv\u00e9e<\/li><li>ce param\u00e8tre est programmable de 30 \u00e0 70 ms<\/li><\/ul><p>\u00a0<\/p><p><strong>Retard AV de s\u00e9curit\u00e9<\/strong><\/p><ul><li>le d\u00e9lai AV de s\u00e9curit\u00e9 est fix\u00e9 \u00e0 100 ms<\/li><li>pour \u00e9viter l'inhibition de l'impulsion ventriculaire en pr\u00e9sence de diaphonie, une impulsion ventriculaire est \u00e9mise \u00e0 la fin du d\u00e9lai AV de s\u00e9curit\u00e9 lorsqu'un signal ventriculaire est d\u00e9tect\u00e9 dans cette fen\u00eatre (\u00e0 partir de la fin de la p\u00e9riode d'inhibition ventriculaire apr\u00e8s Ap).<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f60e4c0 elementor-widget elementor-widget-image\" data-id=\"f60e4c0\" 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\/biotronic1b.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"biotronic4\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjUwMSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL2Jpb3Ryb25pYzFiLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"635\" height=\"363\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1b.png\" class=\"attachment-large size-large wp-image-6501\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1b.png 635w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1b-300x171.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/biotronic1b-18x10.png 18w\" sizes=\"(max-width: 635px) 100vw, 635px\" \/>\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-5205537 elementor-widget elementor-widget-heading\" data-id=\"5205537\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Tachycardie m\u00e9di\u00e9e par un stimulateur cardiaque (r\u00e9ponse PMT)<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6d7ee46 elementor-widget elementor-widget-text-editor\" data-id=\"6d7ee46\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>L'algorithme de d\u00e9tection\/terminaison de la PMT se compose de trois \u00e9l\u00e9ments : la suspicion, la confirmation et la terminaison.<\/p><p><strong>Suspicion<\/strong><\/p><p>Une TPM est suspect\u00e9e lorsque les crit\u00e8res suivants sont remplis :<\/p><ul><li>la fr\u00e9quence cardiaque est sup\u00e9rieure \u00e0 100 bpm<\/li><li>8 cycles successifs de d\u00e9tection du rythme V-A (Vp-As) se sont produits avec une longueur inf\u00e9rieure au crit\u00e8re VA ; ce crit\u00e8re VA est programmable entre 250 et 500 ms (fix\u00e9 nominalement \u00e0 350 ms).<\/li><li>l'\u00e9cart moyen de ces 8 intervalles Vp-As est inf\u00e9rieur au param\u00e8tre du crit\u00e8re de stabilit\u00e9, d\u00e9fini comme \u00e9tant inf\u00e9rieur \u00e0 25 ms<\/li><\/ul><p><strong>\u00a0<\/strong><\/p><p><strong>Confirmation<\/strong><\/p><p>Afin de confirmer la PMT, l'une de ces deux actions est entreprise :<\/p><ul><li>si la PMT suspect\u00e9e se produit \u00e0 l'intervalle de suivi sup\u00e9rieur, l'intervalle de suivi sup\u00e9rieur programm\u00e9 est augment\u00e9 de 50 ms jusqu'\u00e0 la longueur programmable suivante.<\/li><li>si la PMT suspect\u00e9e se produit \u00e0 une vitesse inf\u00e9rieure \u00e0 l'intervalle de suivi sup\u00e9rieur, le d\u00e9lai AV programm\u00e9 est raccourci de 50 ms jusqu'\u00e0 la longueur programmable suivante.<\/li><li>dans les deux cas, si l'intervalle VA mesur\u00e9 reste constant, la PMT est confirm\u00e9e, ce qui fait passer l'algorithme \u00e0 la phase suivante<\/li><\/ul><p>\u00a0<\/p><p><strong>Cessation d'activit\u00e9<\/strong><\/p><p>L'appareil prolonge le PVARP jusqu'\u00e0 l'intervalle VA + 50 ms.<\/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>Biotronik &#8211; AV delay, PMT, refractory periods Content Atrial refractory periods Atrial Refractory Period the atrial refractory period is set by default to AUTO this means that the atrial refractory period is equal to 225 ms; if the AV Delay is programmed longer than 225 ms, the atrial refractory period is extended to match the [&hellip;]<\/p>","protected":false},"author":1,"featured_media":0,"parent":55,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3530","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>Biotronik AV Delay, PMT &amp; Refractory Periods | Pacemaker Guide | Cardiocases<\/title>\n<meta name=\"description\" content=\"Complete Biotronik pacemaker guide: AV delays, PMT prevention, refractory periods &amp; ECG tracings. 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