The role of pacemaker therapy in acute myocardial infarction.

Atrial or ventricular pacing may be helpful during acute myocardial infarction to control drug-resistant arrhythmias. It may also reduce mortality from complete heart block or asystole in individual patients with acute anterior wall myocardial infarction even though statistical reduction in the overall mortality of a group of patients cannot be documented. Permanent pacing should be instituted in a patient who develops second-degree block of the Mobitz Type II or third-degree block during the course of acute anterior wall myocardial infarction to prevent sudden death from the reappearance of the heart block or asystole. The type of pacing and the timing of electrode insertion depends on the experience of the operator and the prevailing conditions.