1. Arrhythmias in Acute Ischaemia Heart Rhythm Service

2. Perfusion of conduction system  SAN  55% atrial branch from RCA  45% proximal branch of Cx

3. Sinus Bradycardia

4. SA Block

5. Sinus Arrest

6. AV Nodal level  PR prolongation  2 nd degree AVB  Complete AVB  Proximal RCA occlusion  Rarely permanent after IMI but pace if persists > 2weeks

8. Infranodal Conduction Abnormalities  New RBBB± LAFB = occlusion proximal to 1 st septal perforator  Ominous prognosis  30% risk of VT or VF within 2 weeks post infarct

9. Infra-nodal Conduction Abnormalities

10. Intra-Hissal Block

11. LBBB and MI Rarely due to ant MI usually RBBB More likely bradycardia dependent LBBB (phase 4)

12. Diagnosis of MI with LBBB ECG is not reliable to diagnose MI in the presence of LBBB

13. Paced ECG and MI identification Cx occlusion

14. Paced ECG and MI

15. Pre excitation MI contralateral to AP mask infarct MI ipsilateral to AP allows recognition

17. Ventricular arrhythmias  Reperfusion arrhythmias

18. AIVR

19. Ventricular arrhythmias  Sustained MMVT - underlying implies underlying scar substrate  NSVT  PVT and VF

21. Supraventricular arrhythmias  AT  AF