In patients with right ventricular paced rhythms, ST-segment elevation of 5 mm or more in leads with discordant QRS polarity can be a reliable indicator of acute myocardial infarction.
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May support AMI suspicion in RV-paced rhythms with ≥5 mm discordant ST elevation; leaves open validation in larger cohorts.
Pelter et al. (2006) studied this question.
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