Conduction disturbances complicating acute myocardial infarction with persistent ST segment elevation are common, especially those of high degree in previous myocardial infarctions. Do these complications occur in the acute phase, before revascularization, with a poor prognosis immediately justifying myocardial reperfusion as well as the placement of an electro systolic training lead. However, their absence before revascularization to occur in post percutaneous reperfusion by angioplasty with placement of an active stent on the culprit artery, with an increase in the ST elevation, is unprecedented and raises as many questions as possible whereas the Stent in place remains permeable. We report the case of a patient presenting, initially, a 3rd degree atrioventricular block after percutaneous revascularization of an ST + extended anteriorly by angioplasty and placement of an active stent on the anterior interventricular coronary artery permeable after a second post-critical coronary angiography.