Why the study?
The study aimed to assess the prevalence of frailty among elderly patients with an implanted cardioverter-defibrillator and evaluate its influence on main endpoints during follow-up.
Does frailty predict ICD shock in elderly patients with an implanted cardioverter defibrillator?
Does frailty predict ICD shock in elderly patients with an implanted cardioverter defibrillator?
Frailty is highly prevalent among elderly patients with ICDs and serves as an independent predictor for both adequate and inadequate ICD shocks.
Frailty may worsen outcomes in elderly ICD patients; leaves open whether routine assessment should guide management.
Introduction: The aim of the study was to assess the prevalence of frailty among elderly patients who had an implanted cardioverter defibrillator, as well as the influence of frailty on the main endpoints during the follow-up. Methods: The study included 103 patients > 60 years of age (85M, aged 71.56–8.17 years). All of the patients had an implanted single or dual-chamber cardioverter-defibrillator. In the research, there was a 12-month follow-up. The occurrence of frailty syndrome was assessed using the Tilburg Frailty Indicator scale (TFI). Results: Frailty syndrome was diagnosed in 75.73% of the patients that were included in the study. The mean values of the TFI were 6.55 ± 2.67, in the physical domain 4.06 ± 1.79, in the psychological domain 2.06 ± 1.10, and in the social domain 0.44 ± 0.55. During the follow-up period, 27.2% of patients had a defibrillator cardioverter electric shock, which occurred statistically more often in patients with diagnosed frailty syndrome (34.6%) compared to the robust patients (4%); p = 0.0062. In the logistic regression, frailty (OR: 1.203, 95% CI:1.0126–1.4298; p < 0.030) was an independent predictor of a defibrillator cardioverter electric shock. Similarly, in the logistic regression, frailty (OR: 1.3623, 95% CI:1.0290–1.8035; p = 0.019) was also an independent predictor for inadequate electric shocks. Conclusion: About three-quarters of the elderly patients that had qualified for ICD implantation were affected by frailty syndrome. In the frailty subgroup, adequate and inadequate shocks occurred more often compared to the robust patients.
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Młynarska et al. (2021) studied this question.
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