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As with refractory ischemia or hemodynamically unstable patients with normal conduction, the 2017 European guidelines emphasize that patients with a clinical suspicion of ongoing myocardial ischaemia and LBBB should be managed in a way similar to STEMI patients, regardless of whether the LBBB is previously knownSuspicion of ongoing myocardial ischaemia is an indication for a primary PCI strategy even in patients without diagnostic ST-segment elevation.[7] Five patients presented with potentially ischemic symptoms

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