Polyethylene drapes used as a physical barrier to cover patients during defibrillation reduced electrical current to acceptable levels for medical personnel to continue compressions throughout defibrillation during cardiac arrest.
The original Sgarbossa criteria have a high specificity (96%) but low sensitivity (36%), meaning it is useful when positive, but a negative result does not rule out MI. The modified Sgarbossa criteria by Smith et al., have a much better sensitivity (91%) with a slight decrease in specificity (90%). You should apply the modified Sgarbossa criteria to evaluate for MI in LBBB and paced rhythms.
In this single center, the Generation 5 high-sensitivity troponin T assay would have allowed acute MI rule out at baseline in 29% of patients and 41% at 30 minutes with 100% NPV and sensitivity. This needs multicenter prospective confirmation, but it shows the future feasibility and utility of high sensitivity troponin pathways.