Table 2.

ACC/AHA recommendations for placement of transcutaneous patches and active (demand) transcutaneous pacing in patients with acute MI²⁰

Class I

Sinus bradycardia (rate < 50 beats/min) with signs of hypotension (systolic blood pressure < 80 mm Hg) that is unresponsive to drug therapy Mobitz type II second-degree AV block Third-degree heart block Bilateral BBB (alternating BBB, or RBBB and alternating LAFB or LPFB) irrespective of time of onset Newly acquired or age-indeterminate LBBB, RBBB with LAFB, or RBBB with LPFB RBBB or LBBB with first-degree AV block

Class IIa

Stable bradycardia (systolic blood pressure > 90 mm Fig, no hemodynamic compromise or compromise responsive to initial drug therapy) Newly acquired or age-indeterminate RBBB

Class IIb

Newly acquired or age-indeterminate first-degree AV block

Class III

Uncomplicated acute MI without evidence of conduction system disease

ACC, American College of Cardiology; AHA, American Heart Association; MI, myocardial infarction; AV atrioventricular; BBB, bundle branch block; RBBB, right bundle branch block; LAFB, left anterior fascicular block; LPFB, left posterior fascicular block; LBBB, left bundle branch block.