Clinical cardiology · 2026
Hypertrophic Cardiomyopathy and the Risk of Bradyarrhythmia and Permanent Pacemaker Implantation: A Nationwide Cohort Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Yang Tsu-An, Hsiao Yu-Yu, Wu Shang-Ju, Chien Yu-Shan, Kuo Ming-Jen, Huang Yu-Shan, Li Guan-Yi, Lin Ching-Heng, Li Cheng-Hung, Lin Jiunn-Cherng, Huang Jin-Long, Chen Yun-Yu, Lo Li-Wei, Lin Yenn-Jiang, Hsieh Yu-Cheng, Chen Shih-Ann
Аннотация
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is associated with various arrhythmias, including bradyarrhythmia. The relationship between HCM and bradyarrhythmia, and subsequent need for permanent pacemaker (PPM) implantation, remains unclear. This study aimed to evaluate the risk of bradyarrhythmia and PPM implantation in HCM patients.
METHODS: This retrospective, population-based cohort study identified patients with newly diagnosed HCM from 2012 to 2017 in Taiwan's National Health Insurance Research Database. Patients with prior bradyarrhythmia or PPM implantation were excluded. A control cohort was selected by matching patients without HCM to the study cohort by age and gender in a 1:1 ratio. The primary and secondary outcomes were the occurrence of bradyarrhythmia and PPM implantation, respectively. A multivariate Cox proportional hazards regression model was used to evaluate the hazard ratios (HR) for the outcomes.
RESULTS: A total of 15 266 patients with a mean age of 63.8 ± 14.5 years constituted the HCM (n = 7633) and control (n = 7633) cohorts. During a follow-up period of 4.05 ± 2.03 years, HCM was associated with higher risks of bradyarrhythmia (adjusted HR: 2.15, p < 0.001) and PPM implantation (adjusted HR: 6.58, p < 0.001). In patients with HCM, the presence of AF increased the risks of both bradyarrhythmia (adjusted HR: 1.61, p < 0.001) and PPM implantation (adjusted HR: 2.12, p < 0.001), while HF increased the risks of PPM implantation (adjusted HR: 1.61, p < 0.001).
CONCLUSIONS: Patients with HCM had higher risks of bradyarrhythmia and PPM implantation. Patients with HCM should be carefully monitored for AF and HF, which might increase the risks of future PPM implantation.
METHODS: This retrospective, population-based cohort study identified patients with newly diagnosed HCM from 2012 to 2017 in Taiwan's National Health Insurance Research Database. Patients with prior bradyarrhythmia or PPM implantation were excluded. A control cohort was selected by matching patients without HCM to the study cohort by age and gender in a 1:1 ratio. The primary and secondary outcomes were the occurrence of bradyarrhythmia and PPM implantation, respectively. A multivariate Cox proportional hazards regression model was used to evaluate the hazard ratios (HR) for the outcomes.
RESULTS: A total of 15 266 patients with a mean age of 63.8 ± 14.5 years constituted the HCM (n = 7633) and control (n = 7633) cohorts. During a follow-up period of 4.05 ± 2.03 years, HCM was associated with higher risks of bradyarrhythmia (adjusted HR: 2.15, p < 0.001) and PPM implantation (adjusted HR: 6.58, p < 0.001). In patients with HCM, the presence of AF increased the risks of both bradyarrhythmia (adjusted HR: 1.61, p < 0.001) and PPM implantation (adjusted HR: 2.12, p < 0.001), while HF increased the risks of PPM implantation (adjusted HR: 1.61, p < 0.001).
CONCLUSIONS: Patients with HCM had higher risks of bradyarrhythmia and PPM implantation. Patients with HCM should be carefully monitored for AF and HF, which might increase the risks of future PPM implantation.