Background: Patients with pacemakers develop heart failure for various reasons. However, prognosis and incidence are unclear in patients with new-onset heart failure.
Objective: We aimed to evaluate the incidence and prognosis of new-onset heart failure in patient with permanent pacemaker(PPM) using a nationwide database from the Health Insurance Review and Assessment Service in South Korea.
Methods: A total of 21,545 participants who underwent PPM from 2010 to 2017 were included. Participants who were diagnosed with HF before the PPM implantation were excluded. New-onset heart failure is determined by one admission event due to heart failure by taking heart failure medication. The primary outcome was new-onset HF. Secondary outcomes were new-onset HF, cardiac resynchronization therapy(CRT), death.
Results: New-onset heart failure was developed in 6.59% (1,420) of participants at baseline. Compared to the non-heart failure group, heart failure group was likely to be older and had higher comorbidities. The incidence of new-onset heart failure was similar in the Sick sinus syndrome(SSS) group and AV block(AVB) group. However, the mortality rate was higher in the AVB group. After multivariable analysis, a new-onset heart failure group had associated with older age(HR 1.3), diabetes(HR 1.19), valvular heart disease(HR 1.4), single chamber PPM(HR 1.35).
Conclusion: New-onset heart failure is significantly associated with CRT upgrade, death in patients with PPM. This study suggests that early treatment of new-onset heart failure may be beneficial in patients with a pacemaker.