{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:14:20Z","timestamp":1790813660496,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Bradyarrhythmia is associated with an increased risk of falls, syncope, and sudden cardiac arrest in Parkinson\u2019s disease (PD). However, studies investigating bradyarrhythmia in PA have been scarce. Therefore, we aimed to assess trends, prevalence, and risk factors of bradyarrhythmia and pacemaker implantation in PD patients. The National Inpatient Sample was utilized to identify patients\u2019 data with primary and secondary diagnoses of Parkinson\u2019s disease (PD) from 2016 to 2020. A total of 333,242 patients had a PD diagnosis; of these, 5092 (1.5%) had comorbid diagnoses of bradyarrhythmia. The prevalence of bradyarrhythmia in patients with PD was 351.9 per 10,000 hospitalizations (3.5%), with an increase from 291.9 to 463.8 per 10,000. However, the trends remained relatively stable. The overall prevalence of pacemaker implantation in patients with PD was 79.9 per 10,000 hospitalizations (0.8%). The overall trend of pacemaker implantation was stable in patients with PD. Age \u2265 65, male sex, and comorbidities (atrial fibrillation, coronary artery disease, heart failure, hypertension, liver failure, obesity, peripheral vascular disease, renal failure) were associated with a higher likelihood of bradyarrhythmia in patients with PD. This study\u2019s findings revealed an increase in the prevalence of bradyarrhythmia. However, the prevalence of pacemaker implantation remained relatively stable over the study period.<\/jats:p>","DOI":"10.3390\/jcdd12070252","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T10:03:48Z","timestamp":1751277828000},"page":"252","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends, Prevalence of Bradyarrhythmia and Pacemaker Implantation in Patients with Parkinson\u2019s Disease"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2028-7816","authenticated-orcid":false,"given":"Tochukwu","family":"Nzeako","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Christiana Care Hospital, Newark, DE 19718, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olayemi","family":"Adeniran","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, SUNY Downstate University Hospital, Brooklyn, NY 11203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoshanah","family":"Kahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northwell Health, Long Island, NY 11542, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Wimmer","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Christiana Care Hospital, Newark, DE 19718, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1038\/s41531-018-0058-0","article-title":"Prevalence of Parkinson\u2019s disease across North America","volume":"4","author":"Marras","year":"2018","journal-title":"NPJ Park. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1002\/mdc3.12568","article-title":"Epidemiology of Parkinson\u2019s Disease-East Versus West","volume":"5","author":"Abbas","year":"2018","journal-title":"Mov. Disord. Clin. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/S0197-4580(02)00065-9","article-title":"Staging of brain pathology related to sporadic Parkinson\u2019s disease","volume":"24","author":"Braak","year":"2003","journal-title":"Neurobiol. Aging"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"281","DOI":"10.2188\/jea.JE20081034","article-title":"Systematic review of the prevalence and incidence of Parkinson\u2019s disease in Asia","volume":"19","author":"Muangpaisan","year":"2009","journal-title":"J. Epidemiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.freeradbiomed.2013.01.018","article-title":"Parkinson disease: From pathology to molecular disease mechanisms","volume":"62","author":"Dexter","year":"2013","journal-title":"Free Radic. Biol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1023\/A:1008823222574","article-title":"A review of health-related quality-of-life concepts and measures for Parkinson\u2019s disease","volume":"8","author":"Damiano","year":"1999","journal-title":"Qual. Life Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S1353-8020(01)00052-9","article-title":"Autonomic dysfunction in Parkinson\u2019s disease: A comprehensive symptom survey","volume":"8","author":"Siddiqui","year":"2002","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1212\/WNL.0b013e31827deb74","article-title":"The spectrum of nonmotor symptoms in early Parkinson disease","volume":"80","author":"Khoo","year":"2013","journal-title":"Neurology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"97","DOI":"10.14802\/jmd.16001","article-title":"Cardiovascular Autonomic Dysfunction in Mild and Advanced Parkinson\u2019s Disease","volume":"9","author":"Kim","year":"2016","journal-title":"J. Mov. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/j.1750-3639.2005.tb00097.x","article-title":"Profound cardiac sympathetic denervation occurs in Parkinson disease","volume":"15","author":"Amino","year":"2005","journal-title":"Brain Pathol. Zurich Switz."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ou, Z., Pan, J., Tang, S., Duan, D., Yu, D., Nong, H., and Wang, Z. (2021). Global Trends in the Incidence, Prevalence, and Years Lived with Disability of Parkinson\u2019s Disease in 204 Countries\/Territories from 1990 to 2019. Front. Public Health, 9.","DOI":"10.3389\/fpubh.2021.776847"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1212\/WNL.0b013e31826c1acd","article-title":"Association of cognitive dysfunction with neurocirculatory abnormalities in early Parkinson disease","volume":"79","author":"Kim","year":"2012","journal-title":"Neurology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.parkreldis.2017.10.003","article-title":"Cardiac sympathetic denervation predicts PD in at-risk individuals","volume":"52","author":"Goldstein","year":"2018","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.14336\/AD.2021.0214","article-title":"The Pathogenesis and Treatment of Cardiovascular Autonomic Dysfunction in Parkinson\u2019s Disease: What We Know and Where to Go","volume":"12","author":"Zhu","year":"2021","journal-title":"Aging Dis."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Lee, B., Edling, C., Ahmad, S., LeBeau, F.E.N., Tse, G., and Jeevaratnam, K. (2023). Clinical and Non-Clinical Cardiovascular Disease Associated Pathologies in Parkinson\u2019s Disease. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241612601"},{"key":"ref_16","unstructured":"(2023, January 23). NIS Database Documentation, Available online: https:\/\/www.hcup-us.ahrq.gov\/db\/nation\/nis\/nisdbdocumentation.jsp."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.autneu.2008.11.012","article-title":"A case of sick sinus syndrome and autonomic failure with Parkinson\u2019s disease","volume":"146","author":"Yamamoto","year":"2009","journal-title":"Auton. Neurosci. Basic Clin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s13760-012-0034-0","article-title":"Sick sinus syndrome and orthostatic hypotension in Parkinson\u2019s disease","volume":"112","author":"Adamec","year":"2012","journal-title":"Acta Neurol. Belg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s10286-023-00962-w","article-title":"Exploring the prevalence of undetected bradyarrhythmia in dementia with Lewy bodies","volume":"33","author":"Heyman","year":"2023","journal-title":"Clin. Auton. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1253\/circj.CJ-21-0947","article-title":"Trend in Age at the Initial Pacemaker Implantation in Patients with Bradyarrhythmia\u2014A 50-Year Analysis (1970\u20132019) in Japan","volume":"86","author":"Matsubara","year":"2022","journal-title":"Circ. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.jacc.2014.03.056","article-title":"Incidence of and risk factors for sick sinus syndrome in the general population","volume":"64","author":"Jensen","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jacc.2004.03.044","article-title":"Electrophysiologic and electroanatomic changes in the human atrium associated with age","volume":"44","author":"Kistler","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1161\/01.CIR.0000121734.47409.AA","article-title":"Electrophysiological and electroanatomic characterization of the atria in sinus node disease: Evidence of diffuse atrial remodeling","volume":"109","author":"Sanders","year":"2004","journal-title":"Circulation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1161\/01.CIR.0000090688.49283.67","article-title":"Electrical remodeling of the atria in congestive heart failure: Electrophysiological and electroanatomic mapping in humans","volume":"108","author":"Sanders","year":"2003","journal-title":"Circulation"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.cger.2012.07.003","article-title":"Epidemiology of arrhythmias and conduction disorders in older adults","volume":"28","author":"Chow","year":"2012","journal-title":"Clin. Geriatr. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1080\/140174301317116280","article-title":"Gender differences in the electrophysiological characteristics of atrioventricular conduction system and their clinical implications","volume":"35","author":"Liu","year":"2001","journal-title":"Scand. Cardiovasc. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e70013","DOI":"10.1002\/joa3.70013","article-title":"Sex based disparities in hospitalization and readmission outcomes for complete atrioventricular block: Insights from United States readmission data","volume":"41","author":"Abdallah","year":"2025","journal-title":"J. Arrhythmia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1002\/mds.27344","article-title":"Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies","volume":"33","author":"Palma","year":"2018","journal-title":"Mov. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1002\/mds.27186","article-title":"Neuropathology of autonomic dysfunction in synucleinopathies","volume":"33","author":"Coon","year":"2018","journal-title":"Mov. Disord."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Grosu, L., Grosu, A.I., Crisan, D., Zlibut, A., and Perju-Dumbrava, L. (2023). Parkinson\u2019s disease and cardiovascular involvement: Edifying insights (Review). Biomed. Rep., 18.","DOI":"10.3892\/br.2023.1607"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1161\/HYPERTENSIONAHA.118.12642","article-title":"Alpha-Synuclein Deposition Within Sympathetic Noradrenergic Neurons Is Associated With Myocardial Noradrenergic Deficiency in Neurogenic Orthostatic Hypotension","volume":"73","author":"Isonaka","year":"2019","journal-title":"Hypertension"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jocn.2018.04.031","article-title":"Cardiac abnormalities in Parkinson\u2019s disease and Parkinsonism","volume":"53","author":"Scorza","year":"2018","journal-title":"J. Clin. Neurosci."},{"key":"ref_33","first-page":"530","article-title":"Heart Matters: Cardiac Dysfunction and Other Autonomic Changes in Parkinson\u2019s Disease","volume":"28","author":"Scorza","year":"2022","journal-title":"Neurosci."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/12\/7\/252\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:01:34Z","timestamp":1760032894000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/12\/7\/252"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":33,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["jcdd12070252"],"URL":"https:\/\/doi.org\/10.3390\/jcdd12070252","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,30]]}}}