[Device therapy after acute coronary syndrome]

Abstract

Acute coronary syndromes are seldom accompanied by high degree AV blocks. Implantation of a permanent pacemaker is rarely necessary.There is a high incidence of ventricular tachyarrhythmias during the acute phase of myocardial infarctions. Sustained VT or VF beyond 48 hours of the infarction indicate the need for an implantable cardioverter-defibrillator. If left ventricular ejecion fraction remains ≤35 % for >40 days an ICD might be indicated for primary prophylaxis.If early after infarction a device implantation becomes necessary, biventricular stimulation should be used if ventricular pacing is necessary or LBBB with markedly increased QRS-duration is present.