Heart failure with preserved ejection fraction may be accompanied by chronotropic incompetence. However, there is a scarcity of data on the incidence and prevalence of permanent pacemaker use in this set of patients or factors associated with its use. The results printed in the American Heart Journal showed that the use of permanent pacemakers is relatively common among patients with heart failure with preserved ejection fraction. Use was reported to be more common among older patients, males, patients with atrial fibrillation, and patients with wider QRS duration.