Mental disorders carry increased long-term mortality risk for patients with permanent pacemakers

For patients with permanent pacemakers, newly diagnosed mental disorders are associated with elevated risk of long-term mortality, according to a study. The association is especially pronounced among younger men and those with early-onset mental disorders.

Researchers used data from the Korean National Health Insurance Service database and identified 19,746 patients who underwent permanent pacemaker implantation and 58,642 propensity score–matched controls without a permanent pacemaker.

The 10‐year cumulative incidence of any newly diagnosed mental disorders among patients with permanent pacemakers was 45.1 percent. The most common diagnoses were depressive disorder (24.6 percent), insomnia (20.6 percent), and anxiety disorder (5.6 percent).

Comparing patients with permanent pacemakers with controls, there was no significant difference observed in the overall risk of detecting new mental disorders (hazard ratio [HR], 0.98, 95 percent confidence interval [CI], 0.96–1.01). However, the risk was higher in the subgroup of male patients with permanent pacemakers, especially those aged <50 years (HR, 1.42, 95 percent CI, 1.16–1.75) or 50–59 years (HR, 1.20, 95 percent CI, 1.04–1.38).

The 10-year cumulative all-cause mortality following permanent pacemaker implantation was significantly higher among patients with any mental disorders vs those who had no mental disorders (53.6 percent vs 31.3 percent; HR, 1.71, 95 percent CI, 1.61–1.82). Patients with schizophrenia had the highest risk of all-cause mortality (HR, 3.23, 95 percent CI, 2.61–4.00).

The risk of all-cause mortality was pronounced in male patients and when mental disorders were diagnosed early after implantation (within 3.2 years).