Impact of Preprocedural Frailty Status in Elderly Transvenous Pacemaker Recipients

Area of Science:

• Cardiology
• Geriatrics
• Medical Devices

Background:

• Transvenous leadless pacemaker (TV-PM) implantations are rising in elderly individuals.
• Frailty syndrome is prevalent in this demographic but its impact on TV-PM outcomes is not well understood.

Purpose of the Study:

• To investigate the association between pre-procedural frailty status and clinical outcomes in elderly TV-PM recipients.
• To identify predictive factors for heart failure admissions in this patient group.

Main Methods:

• Retrospective analysis of 103 patients over 80 years old who underwent TV-PM implantation.
• Frailty status assessed based on walking, cognition, and daily living impairments.
• Primary endpoint: heart failure admission over a mean follow-up of 4.1 years.

Main Results:

• Frailty syndrome was present in 38.8% of patients.
• Frailty syndrome was the sole independent predictor of heart failure admission (HR 1.83, P=0.0157).
• Higher RV pacing burden (>40%) was also a significant univariate predictor (HR 1.58, P=0.0473).

Conclusions:

• Pre-procedural frailty assessment is essential for predicting clinical outcomes in elderly TV-PM recipients.
• Frailty syndrome is a significant risk factor for heart failure admissions post-TV-PM implantation.
• The high incidence of frailty and clinical events underscores the need for targeted management strategies.