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Why might someone with myotonic dystrophy need a pacemaker?

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Myotonic dystrophy is a multisystem disorder that affects various parts of the body beyond the skeletal muscles, including the heart. Individuals with this condition may require a pacemaker because the disease can lead to significant heart problems, such as heart block.123

Heart block occurs when the electrical conduction system of the heart—which regulates the rate and order of contractions—is interrupted. Because myotonic dystrophy is a systemic condition, it can damage the heart's conductive tissue, preventing the necessary electrical signals from reaching the ventricles. In such cases, a pacemaker is used to provide rhythmic electrical impulses to maintain a stable heartbeat and ensure proper cardiac function.31