Treatment of slow heart rates following acute myocardial infarction.

Open Access
Publisher Website
Google Scholar
Abstract
Eleven patients have been treated by artificial pacing for slow heart rates following acute myocardial Infarction. One other patient with cardiac ischemia was paced for syncopal attacks associated with severe angina and slow nodal rhythm. Of the 12 patients, 7 died; the cause of death in 5 was extensive myocardial infarction resulting in an irreversible fall in cardiac output despite satisfactory pacing, and in the other 2 a late recurrence of heart block. Drugs such as atro-pine and isoprenaline for slow rates following acute myocardial infarction have not proved entirely satisfactory, since their response is often unpredictable and dangerous arrhythmias may be produced. A good case can be made for always monitoring the cardiogram following cardiac infarction and treating any evidence of atrio-ventricular block by endocardtal pacing. Since atrio-ventricular block may recur some days after recovery of normal conduction, artificial pacing should be continued for at least 3 wk. unless a reliable ventricular inhibited pacemaker Is availabe. Ectopic foci may be safely suppressed during pacing by procaine amide or (3-blocking agents.