Новодиагностированные психические расстройства у пациентов с кардиостимуляторами повышают риск смертности

Newly diagnosed mental disorders in patients with permanent pacemakers (PPMs), especially younger men and patients with early-onset mental disorders, are associated with significantly higher adverse clinical outcomes and mortality, according to study findings published in the Journal of the American Heart Association. Investigators in Korea assessed the incidence and prognostic implications of newly diagnosed mental disorders among patients with PPMs. The investigators conducted a retrospective population-based cohort study using data from the Korean National Health Insurance Service between 2010 and 2020 to identify patients who received PPM implantation. Individuals with history of heart transplantation or cardiac resynchronization therapy; preexisting mental disorders; or prior implantation of a cardioverter-defibrillator, left ventricular assist device, or PPM were among those excluded from the current study. The study included 19,746 patients who received PPM implantation and 58,642 propensity score-matched control patients without a PPM. Almost half (45.1%) of PPM patients had newly diagnosed mental disorders across the 10-year study period. Depressive disorder (24.6%), insomnia (20.6%), and anxiety disorder (5.6%) were the most common. Newly diagnosed mental disorders among permanent pacemaker patients were associated with significantly higher mortality and adverse clinical outcomes… Although overall risk of detecting new mental disorders among patients with PPMs and the control cohort was similar (hazard ratio [HR], 0.98; 95% CI, 0.96-1.01), a significantly greater risk was noted among men with PPMs (HR, 1.10; 95% CI, 1.05-1.15), especially men aged younger than 50 years (HR, 1.42; 95% CI, 1.16-1.75) and those aged 50 to 59 years (HR, 1.20; 95% CI, 1.04-1.38). This elevated risk progressively decreased with age. Women with PPMs, compared with the control cohort, showed a lower risk for new mental disorders, with an age-related trend of decreasing risk that was similar to the one seen in men. Patients with a PPM diagnosed with any mental disorder, compared with those without mental disorders, had a significantly higher 10-year cumulative all-cause mortality (53.6% vs 31.3%; HR, 1.71; 95% CI, 1.61-1.82). Patients with schizophrenia spectrum disorder had the highest risk (HR, 3.23; 95% CI, 2.61-4.00). More pronounced adverse outcomes, including all-cause mortality, cardiac mortality, and readmission, were noted when mental disorders were diagnosed within a mean of 3.2 years after implantation and among men. Study limitations include the observational design; mental disorder identification relied solely on diagnostic codes, which could lead to possible misclassification among those who did not seek care; and there was no analysis of psychiatric medication use. “Newly diagnosed mental disorders among permanent pacemaker patients were associated with significantly higher mortality and adverse clinical outcomes, with the greatest risks observed in patients with schizophrenia spectrum disorders, those with early-onset mental disorders after implantation, and male patients,” the investigators concluded. This article originally appeared on The Cardiology Advisor References: Kim J, Kim H, Kim H, et al. Incidence and prognostic implications of mental disorders among patients with a permanent pacemaker: a nationwide cohort study. J Am Heart Assoc. Published online July 10, 2026. doi:10.1161/JAHA.125.046035