Bundle branch block in acute myocardial infarction.
The management of patients with acute myocardial infarction complicated by bundle branch block is a significant clinical problem and represents 8% to 13% of patients with acute infarction. This study reviews the records of 606 patients with myocardial infarction admitted to our coronary care unit. Forty-seven (8%) had complete bundle branch block. The risk of developing high-degree AV block in these 47 patients was reviewed. There are no established therapeutic guidelines for patients with pre-existing bundle branch block and left bundle branch block in acute myocardial infarction. We found a high risk of progression in patients with pre-existing bifascicular block in the presence of anterior wall infarction (25%) as well as in patients with left bundle branch block with acute anterior wall infarction (100%). On the basis of our data and careful review of the literature, we recommend prophylactic pacemaker insertion in these high-risk groups.
D002037:Bundle-Branch Block / Q000150:complications*; D003326:Coronary Circulation; D004562:Electrocardiography; D006327:Heart Block / Q000517:prevention & control; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications*; D010138:Pacemaker, Artificial; D012306:Risk