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Implications of primary bradycardia in patients with hypertrophic cardiomyopathy

Jingying Liu1, Lianjun Xu1, Xueyi Wu1

  • 1Cardiomyopathy Ward, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China.

Heart Rhythm
|December 12, 2024
PubMed

Insights

Primary bradycardia, including sinus node dysfunction and atrioventricular block, significantly increases mortality risk in hypertrophic cardiomyopathy patients. This finding highlights the importance of monitoring heart rhythm in HCM for better patient outcomes.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Disease Research

Background:

  • Hypertrophic cardiomyopathy (HCM) research has focused on tachyarrhythmias, leaving primary bradycardia characteristics understudied.
  • Understanding bradycardia in HCM is crucial for comprehensive patient management.

Purpose of the Study:

  • To determine the prevalence, clinical features, and prognostic impact of primary bradycardia in a large cohort of HCM patients.
  • To investigate the association between sinus node dysfunction (SND) and atrioventricular block (AVB) and mortality outcomes in HCM.

Main Methods:

  • Analysis of electrocardiogram data from 1003 hypertrophic cardiomyopathy patients recruited between 1999 and 2019.
  • Assessment of all-cause death, cardiovascular death, and heart failure (HF)-related death as study endpoints.
  • Evaluation of fibrosis patterns and severity in relation to bradycardia presence.

Main Results:

  • 86 out of 1003 HCM patients (8.6%) exhibited primary bradycardia (SND, AVB, or both).
  • Primary bradycardia was associated with more severe cardiac fibrosis.
  • Both isolated SND and isolated AVB significantly increased the risk of all-cause, cardiovascular, and HF-related death; combined SND and AVB conferred a worse prognosis.

Conclusions:

  • Primary bradycardia, encompassing SND and AVB, is an independent predictor of increased mortality in HCM patients.
  • The findings underscore the critical role of identifying and managing bradyarrhythmias in hypertrophic cardiomyopathy.
  • This study offers vital insights into the comprehensive clinical profile and prognosis of HCM patients with primary bradycardia.
Abstract

Keywords:
Atrioventricular blockBradycardiaHeart failureHypertrophic cardiomyopathyPrognosisSinus node dysfunction

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