Temporary Electro-stimulation in the Acute Myocardial Infarction - Two-year Experience

The application of temporary electro-stimulation is necessary in acute myocardial infarction complicated by the appearance of symptomatic bradycardia, AV conduction disturbances and asystolia. During the last two years, 38 of 892 patients (4.2%) with the diagnosis of acute myocardial infraction with ST segment elevation, required temporary electro-stimulation (27 with inferior infractions and 11 with anterior infraction). The third degree AV block was diagnosed in 34 patients (89%). and 4 (11%) patients received prophylactic electro-stimulation due to de novo conduction disturbances (the second degree AV block and block of the left bundle branch2 patients, and block of the left bundle branch-1 patient, and block of the right bundle branch-1 patient, and haemiblock-1 patient). The mortality in the group with anterior infarction was significantly higher than the mortality in the group with inferior infarction (8/11 vs. 5/27, p<0.05). In the group with anterior infarction and temporary electro-stimulation, patients with extensive infarcts had bad prognosis while the presence of right ventricular infraction significantly contributed to the unfavorable outcome in the group with inferior infarction and temporary electro-stimulation. In the group with anterior acute myocardial infraction and temporary electro-stimulation, the duration of QRS complex on admission, expressed in milliseconds was significantly longer in the deceased patients than in the survivors.