The incidence of abnormal conduction has decreased substantially in the reperfusion era. In a survey of nearly 3 million hospi- tal discharges after MI from 1996 to 2003, the incidence of complete heart block was 3.7% in inferior/posterior MI and AV block of varying degree and persistent bundle-branch block develop in approximately 7% and 5% of patients with STEMI, respectively.506,507 High- grade (ie, second- or third-degree) AV block and persistent bundle-branch block are independently associated with worse short- and long-term prognosis in both inferior/posterior and anterior/lateral MI but are more ominous in anterior/lat- eral MI because of a relatively greater extent of myocardial First-degree AV block does not require treatment. High- grade AV block with inferior/posterior STEMI usually is transient and associated with a narrow complex/junc- tional escape rhythm that can be managed conservatively. Application of transcutaneous pacing pads for potential use is reasonable. Prophylactic placement of a temporary pac- ing system is recommended for high-grade AV block and/ or new bundle-branch (especially LBBB) or bifascicular block in patients with anterior/lateral MI. Choice of pacing system (transcutaneous versus transvenous) varies across institutions. Indications for permanent pacing for persis- tent AV block or bundle-branch block after STEMI are reviewed in the 2008 ACC/AHA/HRS device-based therapy 9.6.1. Management of Pericarditis After STEMI: Recommendations Class I 1. Aspirin is recommended for treatment of pericarditis (Level of Evidence: B) Class IIb 1. Administration of acetaminophen, colchicine, or narcotic analgesics may be reasonable if aspirin, even in higher doses, is not effective. (Level of Evidence: C) Class III: Harm 1. 