Objective    To investigate the indications to use a temporary pacemaker for bifascicular block in perioperative period.      Methods    The treatment for 40 patients with heart bifascicular block and a special case were retrospectively studied. All cases

according to their disease history

clinical symptoms

physical ability and atrio-ventricular conduction ability

were divided into two groups: P group (prophylactic insertion of a temporary pacemaker) and N group (without inserting a pacemaker). During operation

we observed whether atrio-ventricular block occurs

the performance of pacemaker and atropine’s therapeutic efficacy to bradycardia.     Results    Anesthesia was postponed in one case because of acute left bundle branch block (LBBB) and the patient died with severe myocardium damage soon after failed resuscitation. All other cases went through anesthesia and operation smoothly. Bradycardia and hypotension could be relieved somewhat by medication in operation

and no complete atrio-ventricular block developed.     Conclusion    There is no need inserting a temporary pacemaker for chronic bifascicular block if asymptomatic and no atrio-ventricular block. Transesophageal atrial pacing is an easy way to evaluate in quantification atrio-ventricular conduction ability.