Heart Rhythm Service Perfusion of conduction system SAN 55 atrial branch from RCA 45 proximal branch of Cx Sinus Bradycardia SA Block Sinus Arrest AV Nodal level PR prolongation 2 ID: 775337
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Slide1
Arrhythmias in Acute Ischaemia
Heart Rhythm Service
Slide2Perfusion of conduction system
SAN
55% atrial branch from RCA
45% proximal branch of
Cx
Slide3Sinus
Bradycardia
Slide4SA Block
Slide5Sinus Arrest
Slide6AV Nodal level
PR prolongation
2
nd
degree AVB
Complete AVB
Proximal RCA occlusion
Rarely permanent after IMI but pace if persists >
2weeks
Slide7Slide8Infranodal 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
Slide9Infra-nodal Conduction Abnormalities
Slide10Intra-Hissal Block
Slide11LBBB and MI
Rarely due to ant MI usually RBBB
More likely
bradycardia
dependent
LBBB (phase 4)
Slide12Diagnosis of MI with LBBB
ECG is not reliable to diagnose MI in the presence of LBBB
Slide13Paced ECG and MI identification
Cx
occlusion
Slide14Paced ECG and MI
Slide15Pre excitation
MI contralateral to AP mask infarct
MI
ipsilateral
to AP allows recognition
Slide16Slide17Ventricular arrhythmias
Reperfusion arrhythmias
Slide18AIVR
Slide19Ventricular arrhythmias
Sustained
MMVT -
underlying implies underlying scar substrate
NSVT
PVT and VF
Slide20Slide21Supraventricular arrhythmias
AT
AF
Slide22