Background & Aims: Bradycardia and conduction disturbances are well recognized complications of acute myocardial infarction (AMI). An important consideration in the setting of an acute myocardial infarction is that a bradycardia, even if asymptomatic or transient, can cause decreased coronary blood flow and reduced myocardial perfusion. Temporary cardiac pacing was commonly useful method preventing myocardial ischemia. This study sought to evaluate the predictors of hospital mortality in AMI patients with temporary cardiac pacing in the Korea. Methods: Total 564 AMI patients (352 males, 66.1짹12.6 year of age) with temporary cardiac pacing were enrolled from Nov 2005 to Jan 2008 in KAMIR. 336 (59.6%) bradycardia, 164 (29.1%) AV block, 1 (0.2%) LBBB, 24 (4.3%) AF/Af patients were involved. Clinical characteristics, 12-lead electrocardiogram (ECG), laboratory examination, echocardiographic, angiographic finding were evaluated. These patients were divided into hospital death. Results: Hospital mortality were 16.7%. PPM was used in 7 patients(1.2%). In multivariate logistic regression, Age [Odds ratio (OR)=1.118; 95% CI=1.040-1.203, p=0.003] and Killip Class III-IV (OR=3.756; 95% CI=1.179-11.962, p=0.025), past history of heart failure (OR=39.001 95% CI=2.306-65.95, p=0.011) LAD lesion (OR=8.7; 95% CI=1.726-43.849, p=0.009) Low ejection fraction (EF<40%)(OR=4.786, 95% CI=1.354-16.913, p=0.015) were independent predictors of hospital mortality after adjustment for clinical, angiographic and procedural data. However, ST change, prior MI and AV block did not affect hospital mortality. Conclusions: KAMIR Registry demonstrated that old age, Low EF, Anterior MI were associated with increased hospital mortality in AMI patients with temporal cardiac pacing.