Diagnosis and management of bradycardia and atrioventricular block associated with acute coronary ischemia.

Bradyarrhythmias arising in the setting of myocardial infarction occur in a significant minority of patients with AMI. In the majority of cases, these abnormalities are owing to myocardial ischemia or infarction with necrosis of the cardiac pacemaker sites and/or conduction system. Other factors responsible for these bradyarrhythmias include altered autonomic influence, systemic hypoxia, electrolyte disturbances, acid-based disorders, and complications of various medical therapies. This article will focus on not only the diagnosis and management of these rhythm disturbances, but also on the pathophysiology of the arrhythmias.