Long-Term Outcomes: Beta-Blocker Use and Permanent Pacing in Patients With Heart Failure Preserved Ejection Fraction.
James K Gabriels1, Kristie Coleman1, Joanna Fishbein2
1Northwell Cardiovascular Institute, Center for Arrhythmias, New Hyde Park, New York, USA.
JACC. Advances
|December 16, 2025
Summary
Heart failure with preserved ejection fraction (HFpEF) patients may benefit from beta-blockers and permanent pacemaker (PPM) implantation. Both therapies were associated with a reduced risk of mortality in this large study.
Area of Science:
- Cardiology
- Clinical Medicine
- Pharmacology
Background:
- Heart failure with preserved ejection fraction (HFpEF) presents a significant global health challenge.
- Current therapeutic options for HFpEF lack proven mortality benefits.
Purpose of the Study:
- To investigate the long-term impact of beta-blocker therapy and permanent pacemaker (PPM) implantation on mortality in HFpEF patients.
- To assess the combined effects of these interventions on patient outcomes.
Main Methods:
- A retrospective cohort study analyzing data from 22,308 patients with HFpEF across 11 hospitals.
- Examined the association of beta-blocker use and PPM implantation with all-cause mortality, hospital readmissions, and emergency department visits.
- Follow-up duration was a median of 1.5 years.
Main Results:
- Discharge on beta-blockers was associated with a 20% lower risk of mortality (HR: 0.80).
- Permanent pacemaker (PPM) implantation at discharge was linked to a 32% reduced risk of mortality (HR: 0.68).
- A significant proportion of patients (44.3%) were discharged on beta-blockers, while 4.2% received a PPM (alone or with beta-blockers).
Conclusions:
- Both beta-blocker therapy and permanent pacemaker (PPM) implantation appear to be independently associated with improved survival in patients with HFpEF.
- These findings suggest potential therapeutic benefits for these interventions in managing HFpEF.
- Further research may elucidate optimal patient selection and treatment strategies.
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