Site de formation à la lecture de l'ElectroCardioGramme.


Mot de passe 
  Arythmie SV
  Arythmie V
Alternance électrique de l’onde T
Alternance électrique des QRS
Atrial(e) ou auriculaire
Axe des QRS
Axe droit ou hyperdroit
Axe gauche ou hypergauche
Axes particuliers
Battement de capture
Complexe de fusion
Complexe d’échappement
Complexe électro-entraîné
Complexe QRS isodiphasique
Complexes QRS ectopiques
Concordance du segment ST
Courant de lésion
Cupule digitalique
Cœur vertical
Déflexion intrinsécoïde
Dérivations concordantes
Déviation axiale
Discordance appropriée
Dissociation auriculo-jonctionnelle
Dissociation auriculo-ventriculaire
Dissociation électromécanique
Dissociation isorythmique
Echappement jonctionnel
Echappement ventriculaire
Écho atrial
Écho ventriculaire
Faisceau de Kent
Fréquence cardiaque
Fusion normalisante
Hypertrophie atriale droite
Hypertrophie atriale gauche
Intervalle P-R
Intervalle Q-T. 3a. QT corrigé (QTc)
Intervalle Q-T. 4a. Long
Intervalle R-R
Intervalle T-P
Inversion bénigne de l’onde T
Lésion sous-endocardique
Lésion sous-épicardique
Ligne de base
Nœud hyperdromique
Onde delta
Onde epsilon
Onde f (fibrillation)
Onde F (Flutter)
Onde J
Onde J d’Osborn
Onde P
Onde P mitrale
Onde P pulmonaire
Onde P rétrograde
Onde P sinusale
Onde Q
Onde q septale
Onde R
Onde S
Onde T
Onde T ample
Onde T atriale (Ta)
Onde T inversée
Onde T inversée profonde
Onde U
Point J
Progression harmonieuse de R
QRS isodiphasiques
Repolarisation atriale
Repolarisation atypique du sujet jeune
Repolarisation féminine
Repolarisation masculine
Repolarisation précoce : anglais
Repolarisation précoce : francais
Repos compensateur
Retard droit
Retard gauche
Rotation antéropostérieure
Rotation transversale
Rythme accéléré
Rythme d échappement
Rythme sinusal
Score de Romhilt-Estes
Segment PR (ou segment PQ)
Segment ST (ou segment JT)
Signe de Spodick
Sous-décalage de PQ (ou PR)
Sous-décalage du ST. généralités
Sous-décalage du ST. les étiologies
Strain pattern 
Super Wolff
Surcharge ventriculaire
Syncope réflexe
Syncope rythmique
Syndrome de préexcitation
Syndrome du P-R court
Syndrome du QT court
Tachycardies: classification ACC 2015
Temps d inscription de l onde R
Transition précoce
Troubles secondaires de repolarisation
Zone de transition
Tachycardies: classification ACC 2015
Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016;133(14):e471-505
Supraventricular tachycardia (SVT) An umbrella term used to describe tachycardias (atrial and/or ventricular rates in excess of 100 bpm at rest), the mechanism of which involves tissue from the His bundle or above. These SVTs include inappropriate sinus tachycardia, AT (including focal and multifocal AT), macroreentrant AT (including typical atrial flutter), junctional tachycardia, AVNRT, and various forms of accessory pathway-mediated reentrant tachycardias. In this guideline, the term does not include AF.
Paroxysmal supraventricular tachycardia (PSVT) A clinical syndrome characterized by the presence of a regular and rapid tachycardia of abrupt onset and termination. These features are characteristic of AVNRT or AVRT, and, less frequently, AT. PSVT represents a subset of SVT.
Atrial fibrillation (AF) A supraventricular arrhythmia with uncoordinated atrial activation and, consequently, ineffective atrial contraction. ECG characteristics include: 1) irregular atrial activity, 2) absence of distinct P waves, and 3) irregular R-R intervals (when atrioventricular conduction is present). AF is not addressed in this document.
Sinus tachycardia Rhythm arising from the sinus node in which the rate of impulses exceeds 100 bpm.
 • Physiologic sinus tachycardia Appropriate increased sinus rate in response to exercise and other situations that increase sympathetic tone.
 • Inappropriate sinus tachycardia Sinus heart rate >100 bpm at rest, with a mean 24-h heart rate >90 bpm not due to appropriate physiological responses or primary causes such as hyperthyroidism or anemia.
Atrial tachycardia (AT)
 • Focal AT An SVT arising from a localized atrial site, characterized by regular, organized atrial activity with discrete P waves and typically an isoelectric segment between P waves. At times, irregularity is seen, especially at onset (“warm-up”) and termination (“warm-down”). Atrial mapping reveals a focal point of origin.
 • Sinus node reentry tachycardia A specific type of focal AT that is due to microreentry arising from the sinus node complex, characterized by abrupt onset and termination, resulting in a P-wave morphology that is indistinguishable from sinus rhythm.
 • Multifocal atrial tachycardia (MAT) An irregular SVT characterized by ≥3 distinct P-wave morphologies and/or patterns of atrial activation at different rates. The rhythm is always irregular.
Atrial flutter
 • Cavotricuspid isthmus–dependent atrial flutter: typical Macroreentrant AT propagating around the tricuspid annulus, proceeding superiorly along the atrial septum, inferiorly along the right atrial wall, and through the cavotricuspid isthmus between the tricuspid valve annulus and the Eustachian valve and ridge. This activation sequence produces predominantly negative “sawtooth” flutter waves on the ECG in leads 2, 3, and aVF and a late positive deflection in V1. The atrial rate can be slower than the typical 300 bpm (cycle length 200 ms) in the presence of antiarrhythmic drugs or scarring. It is also known as “typical atrial flutter” or “cavotricuspid isthmus–dependent atrial flutter” or “counterclockwise atrial flutter.”
 • Cavotricuspid isthmus–dependent atrial flutter: reverse typical Macroreentrant AT that propagates around in the direction reverse that of typical atrial flutter. Flutter waves typically appear positive in the inferior leads and negative in V1. This type of atrial flutter is also referred to as “reverse typical” atrial flutter or “clockwise typical atrial flutter.”
 • Atypical or non–cavotricuspid isthmus–dependent atrial flutter Macroreentrant ATs that do not involve the cavotricuspid isthmus. A variety of reentrant circuits may include reentry around the mitral valve annulus or scar tissue within the left or right atrium. A variety of terms have been applied to these arrhythmias according to the reentry circuit location, including particular forms, such as “LA flutter” and “LA macroreentrant tachycardia” or incisional atrial reentrant tachycardia due to reentry around surgical scars.
Junctional tachycardia A nonreentrant SVT that arises from the AV junction (including the His bundle).
Atrioventricular nodal reentrant tachycardia (AVNRT) A reentrant tachycardia involving 2 functionally distinct pathways, generally referred to as “fast” and “slow” pathways. Most commonly, the fast pathway is located near the apex of Koch’s triangle, and the slow pathway inferoposterior to the compact AV node tissue. Variant pathways have been described, allowing for “slow-slow” AVNRT.
 • Typical AVNRT AVNRT in which a slow pathway serves as the anterograde limb of the circuit and the fast pathway serves as the retrograde limb (also called “slow-fast AVNRT”).
 • Atypical AVNRT AVNRT in which the fast pathway serves as the anterograde limb of the circuit and a slow pathway serves as the retrograde limb (also called “fast-slow AV node reentry”) or a slow pathway serves as the anterograde limb and a second slow pathway serves as the retrograde limb (also called “slow-slow AVNRT”).
Accessory pathway For the purpose of this guideline, an accessory pathway is defined as an extranodal AV pathway that connects the myocardium of the atrium to the ventricle across the AV groove. Accessory pathways can be classified by their location, type of conduction (decremental or nondecremental), and whether they are capable of conducting anterogradely, retrogradely, or in both directions. Of note, accessory pathways of other types (such as atriofascicular, nodo-fascicular, nodo-ventricular, and fasciculoventricular pathways) are uncommon and are discussed only briefly in this document (Section 7).
 • Manifest accessory pathways A pathway that conducts anterogradely to cause ventricular pre-excitation pattern on the ECG.
 • Concealed accessory pathway A pathway that conducts only retrogradely and does not affect the ECG pattern during sinus rhythm.
 • Pre-excitation pattern An ECG pattern reflecting the presence of a manifest accessory pathway connecting the atrium to the ventricle. Pre-excited ventricular activation over the accessory pathway competes with the anterograde conduction over the AV node and spreads from the accessory pathway insertion point in the ventricular myocardium. Depending on the relative contribution from ventricular activation by the normal AV nodal/His Purkinje system versus the manifest accessory pathway, a variable degree of pre-excitation, with its characteristic pattern of a short P-R interval with slurring of the initial upstroke of the QRS complex (delta wave), is observed. Pre-excitation can be intermittent or not easily appreciated for some pathways capable of anterograde conduction; this is usually associated with a low-risk pathway, but exceptions occur.
 • Asymptomatic pre-excitation (isolated pre-excitation) The abnormal pre-excitation ECG pattern in the absence of documented SVT or symptoms consistent with SVT.
 • Wolff-Parkinson-White (WPW) syndrome Syndrome characterized by documented SVT or symptoms consistent with SVT in a patient with ventricular pre-excitation during sinus rhythm.
Atrioventricular reentrant tachycardia (AVRT) A reentrant tachycardia, the electrical pathway of which requires an accessory pathway, the atrium, atrioventricular node (or second accessory pathway), and ventricle.
 • Orthodromic AVRT An AVRT in which the reentrant impulse uses the accessory pathway in the retrograde direction from the ventricle to the atrium, and the AV node in the anterograde direction. The QRS complex is generally narrow or may be wide because of pre-existing bundle-branch block or aberrant conduction.
 • Antidromic AVRT An AVRT in which the reentrant impulse uses the accessory pathway in the anterograde direction from the atrium to the ventricle, and the AV node for the retrograde direction. Occasionally, instead of the AV node, another accessory pathway can be used in the retrograde direction, which is referred to as pre-excited AVRT. The QRS complex is wide (maximally pre-excited).
Permanent form of junctional reciprocating tachycardia (PJRT) A rare form of nearly incessant orthodromic AVRT involving a slowly conducting, concealed, usually posteroseptal accessory pathway.
Pre-excited AF AF with ventricular pre-excitation caused by conduction over ≥1 accessory pathway(s).
  • AF indicates atrial fibrillation; AT, atrial tachycardia; AV, atrioventricular; AVNRT, atrioventricular nodal reentrant tachycardia; AVRT, atrioventricular reentrant tachycardia; bpm, beats per minute; ECG, electrocardiogram/electrocardiographic; LA, left atrial; MAT, multifocal atrial tachycardia; PJRT, permanent form of junctional reciprocating tachycardia; PSVT, paroxysmal supraventricular tachycardia; SVT, supraventricular tachycardia; and WPW, Wolff-Parkinson-White.

Dr Pierre Taboulet
Pierre Taboulet
Hôpital Saint-Louis (APHP)

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