Dmitry Neymark, Christopher Lee, William F. McIntyre, Maria Higgins, James W. Tam, Colette Seifer
{"title":"Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study","authors":"Dmitry Neymark, Christopher Lee, William F. McIntyre, Maria Higgins, James W. Tam, Colette Seifer","doi":"10.1111/anec.70061","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70061","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Noninvasive Electrocardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/anec.70061","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study
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.
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.