Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 141

The bundle branches and fascicles are, at least partially, supplied by the LAD. Anterior MI may lead to bundle branch blocks and AV block. The AV block is Hisian or infra-Hisian and is usually preceded by bundle branch blocks. A high-degree AV block is seen in ~1-2% of anterior MIs and portends a very high mortality related to pump failure (3–4 times increase in mortality; mortality was >50% in the pre-reperfusion era).^152,153 The anterior MI’s AV block often resolves but may recur in a minority of patients.¹⁵³

Transvenous pacing, while indicated for any high-grade second- or third-degree AV block occurring with anterior MI, even if asymp- tomatic, does not improve the grim overall prognosis that is dictated by the pump function. Permanent pacing is indicated for persistent, infranodal second- or third-degree AV block.