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Table 45.7

Indications for Temporary Pacing in Acute Myocardial Infarction

  • Asystole (after restoration of spontaneous rhythm)
  • Complete heart block
  • Right bundle branch block with new left anterior hemiblock or left posterior hemiblock*
  • New left bundle branch block
  • Mobitz type II second-degree AV block
  • Mobitz type I (Wenckebach) second-degree AV block with hypotension not responsive to atropine
  • Sinus bradycardia with hypotension or recurrent sinus pauses not responsive to atropine
  • Atrial or ventricular overdrive pacing for recurrent ventricular tachycardia (seek advice from a cardiologist)

* Left anterior hemiblock gives left axis deviation (S wave > R in lead II); left posterior hemiblock gives right axis deviation (S wave > R in lead I).