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  • Title: Bundle branch block in acute myocardial infarction.
    Author: Hollander G, Nadiminti V, Lichstein E, Greengart A, Sanders M.
    Journal: Am Heart J; 1983 May; 105(5):738-43. PubMed ID: 6846118.
    Abstract:
    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.
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