Pacemaker Induced Hypertrophic Cardiomyopathy (PIHC)

Posted by ginsus @ginsus, Jun 30 4:22pm

My husband's Pacemaker Surgeon just diagnosed my husband with HCM. He has been through the wringer for the past 2 years due to Covid Vaccines and getting Covid twice, anyway. He has 2 stents, an Aortic Valve Replacement, a misplaced pacemaker, a revision to the pacemaker and 2 plugs put into the opening in the Artificial Aortic Valve. On top of that he had RA awakened due to the mRNA vaccines (2). From my research, I found an article that says a Pacemaker can Induce Hypertrophic Cardiomyopathy. Has anyone on this forum experienced this? I am my husband's Research person and he is a retired Dentist.

Interested in more discussions like this? Go to the Hypertrophic Cardiomyopathy (HCM) Support Group.

Debra, Volunteer Mentor | @karukgirl | Jun 30 9:05pm

Hello @ginsus,
That's an interesting question.
It sure does sound like your husband has been through a tough, tough time. I'm sorry he has had so much to deal with. This affects you as well, so you both have been walking a tough road. You must be anxious for some good news for a change!

Hypertrophic Cardiomyopathy is one type of cardiomyopathy of several different types of primary cardiomyopathy...primary meaning not caused by a secondary reason, like your husband's type, which is acquired.

Hypertrophic Cardiomyopathy (HCM) is nearly always caused by a genetic defect, and is congenital. You are born with it.
I found this online, but I get you already knew this:

Pacing-induced cardiomyopathy (PICM) is an acquired heart condition caused by chronic right ventricular (RV) pacing, which induces electrical and mechanical dyssynchrony, leading to left ventricular systolic dysfunction. It affects approximately 12% to 25% of patients with long-term RV pacing, with risk increasing alongside the percentage of time spent in RV pacing mode.

Key aspects of PICM include:

Definition: Typically defined as a >10% decrease in left ventricular ejection fraction (LVEF) resulting in an LVEF ≤50%, in the absence of other causes like coronary artery disease.
Symptoms: Patients may experience standard heart failure signs such as dyspnea on exertion, fatigue, fluid retention, and reduced exercise tolerance.
Risk Factors: Major predictors include high RV pacing burden (>20-40%), male sex, left bundle branch block (LBBB) at baseline, wider paced QRS duration, and pre-existing reduced LVEF.
Management: The primary treatment is upgrading to biventricular cardiac resynchronization therapy (CRT) or conduction system pacing (e.g., His bundle or left bundle branch area pacing), which can reverse ventricular remodeling and improve LVEF.

I am not a doctor, don't play one on TV, and can only share with you what I was able to find online. I was not able to connect a pacer maker to causing a congenital heart disease, which you would be born with.

Is it possible for you to have his cardiologist provide you with more information and write it down, or clarify how they came to this diagnosis?