A new single-center retrospective study has found that the use of guideline-recommended heart medications, i.e., angiotensin receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), and β-blockers (BBs), significantly reduces the risk of developing pacing-induced cardiomyopathy (PICM) over long-term follow-up. The results were published in the Journal of American Heart Association. 

The study included 642 patients with normal ejection fraction and complete heart block who underwent pacemaker implantation. Among them, 211 patients received medical therapy (ACEI/ARB, BB, or both), while 431 received neither. The primary endpoint was the development of PICM, defined as either the need for an upgrade to a biventricular device or a reduction in ejection fraction to ≤40% without another identifiable cause.

Over a 10-year follow-up, PICM occurred in a lower number of patients in the medical therapy group compared with the control group (4.7% vs. 7%). 

As reported by adjustment analysis, there was an association between the medical therapy and significantly lower risk of PICM (hazard ratio [HR], 0.59). Patients receiving combination therapy with both ACEI/ARB and BB had the greatest benefit (HR, 0.46).