Percutaneous coronary intervention for persistent complete heart block complicating inferior myocardial infarction.

Current guidelines recommend implantation of permanent pacemakers for advanced atrioventricular block complicating acute myocardial infarction (MI) when the block is present beyond the usual hospital course. In patients with inferior MI, such blocks are usually transient, but they can also be persistent. However, they are not considered as primary indications for early reperfusion by percutaneous coronary intervention (PCI) in the absence of ongoing ischemia. We describe a patient with inferior MI in whom a successful PCI was effective in reversing persistent complete heart block, thus avoiding implantation of a permanent pacemaker. In selected patients with inferior MI and advanced atrioventricular block, PCI should be considered as a treatment option before recommending permanent pacemaker implantation.