Abstract
SummaryThirty‐three patients in whom complete heart block complicated acute myocardial infarction are described. The patients can be divided into three groups of comparable size on the basis of the treatment they received.In one group hæmodynamic complications of complete heart block were treated with sympathomimetic drugs and steroids; in another group transvenous endocardial pacing was used for similar indications. The third group was monitored in the coronary care unit and pacing was started electively at the time of diagnosis of complete heart block.Ten of the 33 patients survived, in nine of whom the heart returned to sinus rhythm; one required permanent pacing.The incidence of previous myocardial infarction was high among the patients in this study, and its presence had a markedly adverse effect on prognosis. The outlook was favourable if hæmodynamic complications did not develop, or if the response to pacing was prompt when these did occur.
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