What are the indications for permanent pacing for persistent AV block or bundle-branch block after STEMI?
The indications for permanent pacing for persistent AV block or bundle-branch block after STEMI are as follows: high-grade AV block with inferior/posterior STEMI usually is transient and associated with a narrow complex/junctional escape rhythm that can be managed conservatively. Application of transcutaneous pacing pads for potential use is reasonable. Prophylactic placement of a temporary pacing system is recommended for high-grade AV block and/or new bundle-branch (especially LBBB) or bifascicular block in patients with anterior/lateral MI. Choice of pacing system (transcutaneous versus transvenous) varies across institutions. 