SummaryFacilities for temporary electrical pacing were created in a district general hospital. In consequence, a more than twofold increased proportion of patients with acute myocardial infarction who developed electrical conduction defects were treated with temporary electrical pacing. Despite the increased use of pacing, however, the mortality among patients with conduction defects did not decline at all. It is concluded that the widespread reluctance to undertake a formal clinical trial of temporary electrical pacing among patients with acute myocardial infarction is no longer warranted.