Neymark Dmitry, Lee Christopher, McIntyre William F, Higgins Maria, Tam James W, Seifer Colette
Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Division of Cardiology, University of Calgary, Calgary, Alberta, Canada.
Ann Noninvasive Electrocardiol. 2025 Mar;30(2):e70061. doi: 10.1111/anec.70061.
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.
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.
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.
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.
衰弱使个体易患疾病和死亡。越来越多的老年人和患有合并症的个体正在接受一级预防植入式心脏复律除颤器（ICD）植入。关于衰弱与装置植入后结局之间的关联知之甚少。
我们对71例接受一级预防ICD植入且使用弗里德指数评估了基线衰弱状态的患者进行了单中心前瞻性队列研究。参与者的中位随访期为7.8年。
平均年龄（±标准差）为70.6±4.5岁。12例（17%）患者符合衰弱标准。23例（33%）患者接受了心脏再同步治疗。衰弱与死亡率（HR[95%CI]；3.9[1.2 - 12.1]）、急诊就诊（2.7[1.1 - 6.7]）和住院率（2.8[1.1 - 7.6]）显著升高相关。在非衰弱队列中，弗里德衰弱评分与不良结局之间无关联。没有衰弱患者接受适当的电击治疗。
在一级预防ICD接受者中，衰弱与更差的死亡率和发病率相关。临床医生在与该患者群体讨论风险和益处时应考虑衰弱因素。
