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* * * * * * * * * * * * We will start by discussing normal impulse fomation and then move into common conduction disturbances. As abnormal conduction is discussed we will correlate the AHA/ACC guidelines for pacemaker implantation related to that particular rhythm. * * * * * * * * * * * * * * * * * * * * * * * * * * Sinus bradycardia occurs when the SA node fires at a slow ( 60 bpm) rate. * * * * * * Sinus bradycardia occurs when the SA node fires at a slow ( 60 bpm) rate. * * * * Sinus arrest occurs when there is a pause in the rate at which the SA node fires. With sinus arrest there is no relationship between the pause and the basic cycle length. * * * * * * * * * * * * We will start by discussing normal impulse fomation and then move into common conduction disturbances. As abnormal conduction is discussed we will correlate the AHA/ACC guidelines for pacemaker implantation related to that particular rhythm. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RIGHT CORONARY ARTERY The right coronary artery lies in a groove between the right atrium and right ventricle and loops around the lower side of the heart to the posterior side of the heart. It supplies blood and oxygen to the right atrium and right ventricle, the inferior wall of the left ventricle, and the posterior 1/3rd of the intraventricular septum. It also supplies the SA node in 55% of the population and to the AV node in 90% of the population. In 80% of the population, the RCA gives rise to the posterior descending coronary artery (PDA). This is known as “right dominance”. LEFT MAIN CORONARY ARTERY The left coronary artery system supplies blood to the muscle of the left ventricle. The left main divides almost immediately into two large branches: LEFT ANTERIOR DESCENDING (LAD) The LAD branch travels down the anterior wall of the left ventricle and supplies blood to approximately 2/3rds of the septum, the right buncle branch and the anterior super
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