{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:29:14Z","timestamp":1787754554856,"version":"build-2784847793"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH\u20101123102C"],"award-info":[{"award-number":["TCVGH\u20101123102C"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH\u20101123102D"],"award-info":[{"award-number":["TCVGH\u20101123102D"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH\u20101137301C"],"award-info":[{"award-number":["TCVGH\u20101137301C"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH\u20101137305D"],"award-info":[{"award-number":["TCVGH\u20101137305D"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH\u2010113G241"],"award-info":[{"award-number":["TCVGH\u2010113G241"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH\u2010VTA113A12"],"award-info":[{"award-number":["TCVGH\u2010VTA113A12"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective, population\u2010based 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 15\u2009266 patients with a mean age of 63.8\u2009\u00b1\u200914.5 years constituted the HCM (\n n<\/jats:italic>\n \u2009=\u20097633) and control (\n n<\/jats:italic>\n \u2009=\u20097633) cohorts. During a follow\u2010up period of 4.05\u2009\u00b1\u20092.03 years, HCM was associated with higher risks of bradyarrhythmia (adjusted HR: 2.15,\n p<\/jats:italic>\n \u2009<\u20090.001) and PPM implantation (adjusted HR: 6.58,\n p<\/jats:italic>\n \u2009<\u20090.001). In patients with HCM, the presence of AF increased the risks of both bradyarrhythmia (adjusted HR: 1.61,\n p<\/jats:italic>\n \u2009<\u20090.001) and PPM implantation (adjusted HR: 2.12,\n p<\/jats:italic>\n \u2009<\u20090.001), while HF increased the risks of PPM implantation (adjusted HR: 1.61,\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/clc.70454","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:42:52Z","timestamp":1787726572000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypertrophic Cardiomyopathy and the Risk of Bradyarrhythmia and Permanent Pacemaker Implantation: A Nationwide Cohort Study"],"prefix":"10.1002","volume":"49","author":[{"given":"Tsu\u2010An","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Family Medicine Changhua Christian Hospital Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6103-5280","authenticated-orcid":false,"given":"Yu\u2010Yu","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6095-738X","authenticated-orcid":false,"given":"Shang\u2010Ju","family":"Wu","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Shan","family":"Chien","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"},{"name":"Department of Data Science and Big Data Analytics, and Department of Financial Engineering Providence University Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Jen","family":"Kuo","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Shan","family":"Huang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0550-8837","authenticated-orcid":false,"given":"Guan\u2010Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Heng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Research Taichung Veterans General Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Hung","family":"Li","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"},{"name":"Department of Data Science and Big Data Analytics, and Department of Financial Engineering Providence University Taichung Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, Cardiovascular Research Center College of Medicine, National Chung Hsing University Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiunn\u2010Cherng","family":"Lin","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"},{"name":"Department of Data Science and Big Data Analytics, and Department of Financial Engineering Providence University Taichung Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, Cardiovascular Research Center College of Medicine, National Chung Hsing University Taichung Taiwan"},{"name":"Department of Telemedicine Center Taichung Veterans General Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6566-5546","authenticated-orcid":false,"given":"Jin\u2010Long","family":"Huang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, Cardiovascular Research Center College of Medicine, National Chung Hsing University Taichung Taiwan"},{"name":"Department of Medical Education Taichung Veterans General Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun\u2010Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"},{"name":"Department of Medical Research Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, Cardiovascular Research Center College of Medicine, National Chung Hsing University Taichung Taiwan"},{"name":"Heart Rhythm Center and Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9102-227X","authenticated-orcid":false,"given":"Li\u2010Wei","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"},{"name":"Heart Rhythm Center and Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8395-1052","authenticated-orcid":false,"given":"Yenn\u2010Jiang","family":"Lin","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"},{"name":"Heart Rhythm Center and Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6218-7139","authenticated-orcid":false,"given":"Yu\u2010Cheng","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"},{"name":"Department of Data Science and Big Data Analytics, and Department of Financial Engineering Providence University Taichung Taiwan"},{"name":"Department of Medical Research Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, Cardiovascular Research Center College of Medicine, National Chung Hsing University Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Ann","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"},{"name":"Department of Medical Research Taichung Veterans General Hospital Taichung Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, Cardiovascular Research Center College of Medicine, National Chung Hsing University Taichung Taiwan"},{"name":"Heart Rhythm Center and Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei 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