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Which of the following statements is true for this patient? A 53-year-old woman is admitted to the hospital after having an acute inferior myocardial infarction. Within hours of admission, she develops third-degree AV block but remains hemodynamically stable.



A. Conduction abnormalities are uncommon in the setting of an acute myocardial infarction
B. Temporary pacing does not necessarily imply a need for permanent pacing because conduction abnormalities are often transient in the acute setting
C. In an inferior infarction, conduction abnormalities often persist and so necessitate a permanent pacemaker
D. Patients with inferior infarction are more likely to require permanent pacing than those with anterior infarction

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Pacemaker Therapy
Asked by Eliana, Last updated: Mar 28, 2020

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2 Answers

A. Cook

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A. Cook, English Professor, M.A, Ph.D, Kentucky

Answered Feb 21, 2019

Correct answer is option B
Temporary pacing does not necessarily imply a need for permanent pacing because conduction abnormalities are often transient in the acute setting.

This statement above is true. Conduction abnormalities are common in the setting of an acute myocardial infarction, conduction abnormalities usually resolve after acute phase of infarction and after revascularization.

Temporary pacing may be required during the acute phase of infarction, but there is no need for a permanent pacemaker since conduction abnormalities since the conducting system regains it pace. Patients with anterior infarction are much more likely to require permanent pacing than inferior infarction.

 

John Smith

John Smith

Answered Sep 08, 2016

Temporary pacing does not necessarily imply a need for permanent pacing because conduction abnormalities are often transient in the acute setting-key concept/objective: conduction abnormalities are common in the acute infarction period but they tend to be transient and do not necessarily imply a need for permanent pacing conduction abnormalities are common in the setting of acute myocardial infarction. pathophysiologic mechanisms include ischemia, necrosis, autonomic influences, and the neurohumoral response to injury. temporary transvenous pacing is occasionally required during the acute phase of an infarction. the need for temporary pacing does not necessarily imply a need for permanent pacing, since many of the conduction abnormalities are transient and resolve after revascularization or upon recovery from the acute phase of the infarction. patients with acute inferior infarction can manifest a variety of abnormalities, including sa node dysfunction, first-degree av block, type i second-degree block, and third-degree block at the level of the av node. it is uncommon for any of these conduction disturbances to persist after the acute phase of the infarction. these patients often require temporary pacing if they manifest hemodynamic instability, but they rarely require permanent pacing. patients with anterior infarction can manifest bundle branch block, bifascicular block, trifascicular block, type ii second-degree block, or complete heart block. these patients are much more likely to require permanent pacing than those with inferior infarction.
 

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