Effects of reperfusion on complete heart block complicating anterior myocardial infarction

Two patients with complete heart block complicating extensive anterior myocardial infarction underwent late (>40 hours) coronary reperfusion with angioplasty. One to one atrioventricular conduction was restored within minutes of reperfusion despite a lack of measurable ventricular muscle salvage as demonstrated by ventriculography 1 week later. The evidence favors reversible ischemia rather than extensive necrosis of the proximal conduction system as the mechanism of heart block in this subgroup of patients