Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2025-03-14 DOI:10.1111/anec.70061

Dmitry Neymark, Christopher Lee, William F. McIntyre, Maria Higgins, James W. Tam, Colette Seifer

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Abstract

Background

Frailty predisposes individuals to morbidity and mortality. Increasing numbers of elderly and comorbid individuals are undergoing primary prevention implantable cardioverter defibrillator (ICD) device placement. Little is known about the association of frailty with post-device implantation outcomes.

Methods

We conducted a single-center, prospective cohort study of 71 patients who underwent primary prevention ICD insertion and who had their baseline frailty status assessed using the Fried index. Participants were followed for a median period of 7.8 years.

Results

The mean age (± SD) was 70.6 ± 4.5 years. 12 (17%) patients met the criteria for frailty. 23 (33%) patients received cardiac resynchronization therapy. Frailty was associated with a significantly higher incidence of mortality (HR [95% CI]; 3.9 [1.2–12.1]), ED visits (2.7 [1.1–6.7]), and hospitalizations (2.8 [1.1–7.6]). Within the non-frail cohort, there was no association between Fried frailty scores and adverse outcomes. None of the frail patients received appropriate shock therapy.

Conclusion

Among primary prevention ICD recipients, frailty is associated with worse mortality and morbidity. Clinicians should consider frailty when discussing risks and benefits with this patient population.

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背景虚弱容易导致发病和死亡。越来越多的老年人和合并症患者正在接受一级预防植入式心律转复除颤器（ICD）装置植入手术。人们对虚弱与设备植入后结果的关系知之甚少。方法我们对 71 名接受一级预防 ICD 植入术的患者进行了单中心前瞻性队列研究，并使用弗里德指数评估了他们的基线虚弱状态。参与者的随访时间中位数为 7.8 年。结果平均年龄（± SD）为 70.6±4.5 岁。12（17%）名患者符合虚弱标准。23（33%）名患者接受了心脏再同步化治疗。体弱与死亡率（HR [95% CI]；3.9 [1.2-12.1]）、急诊室就诊率（2.7 [1.1-6.7]）和住院率（2.8 [1.1-7.6]）明显较高有关。在非虚弱人群中，弗里德虚弱评分与不良后果之间没有关联。所有体弱患者均未接受适当的电击治疗。结论在一级预防 ICD 患者中，体弱与死亡率和发病率的恶化有关。临床医生在与这一患者群体讨论风险和获益时应考虑体弱因素。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.