ECG Inferior wall Myocardial infarction with variable block

A 52 year old male patient comes to JIPMER,Pondicherry, India with  chief complaints of acute onset retrosternal chest pain of 6 hours duration along with perpiration, vomiting. Patient was a known case of Diabetes mellitus, hypertension. Patient was a chronic smoker. ECG done in the emergency department is shown below

ECG 1

Description of the ECG-Sinus rhythm at around 28 beats per minute, PR interval 440 msec, junctional beats seen, heart rate around 70 beats per minute, QT interval 420 msec, ST segment elevation in lead II,III,avF, with ST segment depression in lead I, avL, V2-V4 suggestive of inferior wall myocardial infarction with 1 degree AV node block with junctional escape beats with sinus bradycardia 

                                                                  ECG 2

Second ECG of the patient after sometime showing AV dissociation with atrial rate around 100 beats per minute, ventricular rate 60 beats per minute, ST elevation present in lead II,III,avF, there is no consistent relationship between P wave and QRS wave suggestive of complete heart block.