[Late recurrence of atrioventricular block in acute anterior and/or septal myocardial infarcts. Discussion of the implantation of a permanent pacemaker. Apropos of 2 cases].

Does the high incidence of post hospital sudden death in patients surviving acute anterior and or septal infarction complicated by transient intraventricular or atrioventricular block have any relation to a late recurrence of the conduction defect and is prophylactic permanent pacing justified from the outset? These questions remain controversial and, to illustrate the problem, two cases of infarction, one an extensive anterior infarct and the other a deep septal infarct are reported. Both developed late recurrences of atrioventricular block without recurrent myocardial infarction requiring permanent pacing. In practice, the usual poor prognosis of these infarcts make comparative survival studies very difficult. The authors suggest permanent pacing for a very restricted group of patients surviving acute anterior and or septal infarction complicated by transient complete atrioventricular block.