HCM was associated with higher risks of bradyarrhythmia (adjusted HR: 2.15) and PPM implantation (adjusted HR: 6.58), with AF and HF further increasing these risks in HCM patients.
Hypertrophic cardiomyopathy was associated with a significantly higher risk of bradyarrhythmia compared to matched controls.
Hypertrophic cardiomyopathy was associated with a markedly higher risk of permanent pacemaker implantation compared to matched controls.
In HCM patients, the presence of atrial fibrillation increased the risks of both bradyarrhythmia and PPM implantation.
In HCM patients, the presence of heart failure increased the risk of PPM implantation.
This study used a retrospective, population-based cohort design drawing from Taiwan's National Health Insurance Research Database to identify newly diagnosed HCM patients.
This research suggests that people diagnosed with hypertrophic cardiomyopathy (HCM) — a condition where the heart muscle becomes abnormally thick — face substantially higher risks of developing slow heart rhythms (bradyarrhythmia) and needing a permanent pacemaker compared to people without HCM. Using data from Taiwan's national health insurance system, researchers followed over 15,000 people (half with HCM, half without) for about four years and found that HCM patients were more than twice as likely to develop bradyarrhythmia and more than six times as likely to require a pacemaker. The study also found that among HCM patients, those who also had atrial fibrillation (an irregular, often rapid heart rhythm) faced even greater risks — about 61% higher risk of bradyarrhythmia and more than double the risk of needing a pacemaker. Similarly, HCM patients who also had heart failure had a 61% higher risk of needing a pacemaker. These findings highlight that HCM is not only linked to fast or irregular heart rhythms, but also to dangerously slow ones. This research suggests that clinicians caring for HCM patients should actively monitor for atrial fibrillation and heart failure, as these conditions may signal an elevated likelihood of needing a pacemaker in the future. The large, nationwide dataset strengthens confidence in these findings, though the retrospective design means that cause-and-effect relationships cannot be definitively established.
Yang T, Hsiao Y, Wu S, Chien Y, Kuo M, Huang Y, et al.. (2026). Hypertrophic Cardiomyopathy and the Risk of Bradyarrhythmia and Permanent Pacemaker Implantation: A Nationwide Cohort Study.. Clinical cardiology. https://doi.org/10.1002/clc.70454