{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T07:08:11Z","timestamp":1789110491802,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myotonic dystrophy type 1 (DM1) is associated with progressive cardiac conduction disease, heart failure (HF) and increased mortality. However, the association of incident HF with conduction disease and survival in DM1 is not well defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether adults with pre\u2010existing DM1 who develop incident HF experience higher rates of advanced conduction disease, permanent pacemaker or ICD\/CRT\u2010D implantation, and mortality compared with matched HF controls without DM1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study using the TriNetX database to identify adults with incident HF and pre\u2010existing DM1 from 2013\u20132023. Patients with DM1 were propensity matched 1:1 to HF controls without DM1. The primary outcome was incident advanced conduction disease. Secondary outcomes included permanent pacemaker implantation, ICD or CRT\u2010D implantation, bundle branch block or intraventricular conduction delay, ventricular tachycardia or fibrillation, cardiac arrest, and all\u2010cause mortality. Outcomes were assessed over three years using risk ratios and time\u2010to\u2010event analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 815 DM1 patients matched to 815 HF patients without DM1. Compared with matched HF controls, patients with DM1 had higher risks of advanced conduction disease (RR 2.45, 95% CI 1.61\u20133.74) and ICD\/CRT\u2010D implantation (RR 2.56, 95% CI 1.24\u20135.30), as well as higher all\u2010cause mortality (HR 1.82, 95% CI 1.45\u20132.29). Permanent pacemaker implantation did not differ significantly between groups (RR 1.22, 95% CI 0.53\u20132.80). Bundle branch block or intraventricular conduction delay was more frequent in DM1, while ventricular tachyarrhythmias and cardiac arrest did not differ significantly between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients with incident HF, those with DM1 represent a distinctly high\u2010risk subgroup with substantially elevated rates of advanced conduction disease, ICD\/CRT\u2010D implantation, and mortality compared with matched HF controls. These findings identify the intersection of DM1 and HF as a clinical state warranting closer rhythm surveillance and earlier electrophysiology assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70421","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T06:44:18Z","timestamp":1789109058000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced Conduction Disease After Incident Heart Failure in Myotonic Dystrophy Type 1"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6142-9183","authenticated-orcid":false,"given":"Isadora","family":"Guarino","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Elman","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2248-5139","authenticated-orcid":false,"given":"Gregory","family":"Supple","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Section, Division of Cardiovascular Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8369-0259","authenticated-orcid":false,"given":"Saman","family":"Nazarian","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Section, Division of Cardiovascular Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"6","key":"e_1_2_10_2_1","first-page":"507","article-title":"Consensus\u2010Based Care Recommendations for Adults With Myotonic Dystrophy Type 1","volume":"8","author":"Ashizawa T.","year":"2018","journal-title":"Neurology: Clinical Practice"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1546325"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062800"},{"issue":"32","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"2158","DOI":"10.1093\/eurheartj\/ehu157","article-title":"Cardiac Involvement in Myotonic Dystrophy: A Nationwide Cohort Study","volume":"35","author":"Lund M.","year":"2014","journal-title":"European Heart Journal"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/121.8.1557"},{"issue":"8","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1212\/WNL.52.8.1658","article-title":"A 10\u2010Year Study of Mortality in a Cohort of Patients With Myotonic Dystrophy","volume":"52","author":"Mathieu J.","year":"1999","journal-title":"Neurology"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.346"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw569"},{"issue":"6","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1016\/j.ahj.2010.07.032","article-title":"Increased Mortality With Left Ventricular Systolic Dysfunction and Heart Failure in Adults With Myotonic Dystrophy Type 1","volume":"160","author":"Bhakta D.","year":"2010","journal-title":"American Heart Journal"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.08.037"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.4145"},{"issue":"10","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1016\/j.hrthm.2012.06.032","article-title":"Assessment of Cardiac Involvement in Myotonic Muscular Dystrophy by T1 Mapping on Magnetic Resonance Imaging","volume":"9","author":"Turkbey E. 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