Acute atrial infarction precipitating sinus node dysfunction with challenging pacemaker placement and subsequent pericarditis

Key Teaching Points1. Atrial infarction is an important, yet under-recognized cause of new arrhythmias associated with myocardial infarction.2. Pacemaker placement in a patient with atrial infarction can be complicated by poor right atrial lead sensing and capture that may be resolved by lead placement in a septal position.3. Pericarditis may be observed following ATMI, especially with difficult pacemaker placement, and requires recognition to be distinguished from ACS.