Pacemakers are available for the treatment of hypertrophic cardiomyopathy, especially in patients with left ventricular outflow tract obstruction. In the 1970s, the use of pacemakers for hypertrophic cardiomyopathy was proposed, mainly through apical pacing of the right ventricle, thus changing the contraction sequence of the heart to reduce outflow tract obstruction. Currently, the most common is the active spiral electrode, in which the pacing electrode is placed at the right ventricular apex to depolarize the ventricular septum and contraction lag, offsetting it to the right ventricular side during systole and creating a reverse motion with the left ventricular free wall, thereby increasing the area of the left ventricular outflow tract during systole, thereby reducing the pressure step difference in the outflow tract and improving hypertrophic cardiomyopathy symptoms and activity tolerance. However, not all types of hypertrophic cardiomyopathy are suitable for pacemaker implantation. It is necessary to consult a specialized physician to clarify the indications before proceeding with treatment.