Timing and indications for pacemaker implantation in patients with myocardial infarction complicated by atrioventricular block

Dynamics of atrioventricular conduction disturbances, indications for pacem aker implantation and its optimal timing were evaluated in 195 patients wit h acute myocardial infarction complicated by II-III degree atrioventricular block, In 135 patients (69,2%) temporary transvenous pacing was carried ou t, In 32 patients (16,1%) pacemakers were implanted in 12-25 days (average 16,4+/-1,5 days) after onset of infarction. Reason for permanent pacing was persistence of II-III degree atrioventricular block (2:1 type or far advan ced) combined with His bundle branch block for more than 2 weeks, The follo wing factors were considered in determination of timing of pacemaker implan tation: characteristics of clinical course of the disease (with recurrences or prolonged, with involvement of right ventricle), presence of other comp lications (acute ventricular aneurysm, thromboendocarditis, thromboembolism ), reaction of hemodynamics to temporary pacing (compensation or persistenc e of decompensation), effect of stimulation of atrioventricular conduction with drugs, dynamics of laboratory tests and ECC.