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Sgarbossa criteria appear to predict acute MI in patients with pacemakers. The criteria have low sensitivity but are very specific. Criteria C (excessively discordant ST-segment elevation) seem to be most specific in patients with pacemakers.
Final Class IIB Take-home points
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Concordant STE ≥ 1mm (in any lead) = Most specific for MI
Concordant STD ≥ 1mm in V1, V2, or V3 = Specific for MI
Discordant STE ≥ 5mm = Less specific for MI
4. Non-STE ACS (Class IA in national guidelines)