Permanent pacing in patients with transient trifascicular block during acute myocardial infarction |
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Authors: | William S Ritter James M Atkins CGunnar Blomqvist Charles B Mullins |
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Institution: | 1. From Parkland Memorial Hospital and the Pauline and Adolph Weinberger Laboratory for Cardiopulmonary Research, Department of Internal Medicine, University of Texas Health Science Center at Dallas Dallas, Texas U.S.A.;2. Southwestern Medical School, Dallas, Texas U.S.A. |
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Abstract: | Patients with acute myocardial infarction and transient complete atrioventricular (A-V) block in association with right bundle branch block and left anterior hemiblock have a high incidence rate of late sudden death presumably due to recurrent A-V block. Over a 5 year period, 18 patients demonstrated right bundle branch block and left anterior hemiblock and had transient complete block during an acute myocardial infarction and survived to hospital discharge. Of six patients who did not have permanent pacing, five died suddenly (one was lost to follow-up) with a mean survival time of 2.4 months after hospital discharge. Twelve subsequent patients received permanent demand pacemakers and had a significantly improved prognosis with a mean survival time of 18 months (P < 0.001). Six patients were still alive at an average follow-up time of 20 months. Prophylactic permanent pacing significantly improves the prognosis after acute myocardial infarction in this select subgroup of patients. |
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Keywords: | Address for reprints: James M Atkins MD Cardiopulmonary H8 116 The University of Texas Health Science Center at Dallas 5323 Harry Hines Blvd Dallas Texas 75235 |
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