Conservative treatment of AV block in acute myocardial infarction. Results in 105 consecutive patients.

are reported. Second and third degree AV block occurred in I05 of i665 patients. Isoprenaline intravenously was used when clinically necessary and pacemaker only if isoprenaline failed to improve heart rate. Forty-four patients received no specific therapy, 47 received isoprenaline only, and I4 transvenous pacemaker therapy. Few complications of isoprenaline therapy were observed, which is ascribed to relatively small doses and careful adjustment if necessary. The overall mortality was 47 per cent. Though the results did not differ significantly from those in compiled reports on routine use ofpacemaker they show that AV block in acute myocardial infarction carries a high mortality despite conventional drug therapy. An analysis of the causes showed that associated complications of a large infarction are probably often implicated, but also that refined pacemaker methods combined with drugs may offer hope of better results.