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Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter

Dmitry Neymark1, Christopher Lee2, William F McIntyre3

  • 1Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|March 14, 2025
PubMed

Insights

Frailty significantly increases mortality and morbidity risks in patients receiving primary prevention implantable cardioverter defibrillators (ICDs). Frail individuals face higher rates of death, emergency department visits, and hospitalizations post-implantation.

Area of Science:

  • Gerontology
  • Cardiology
  • Clinical Medicine

Background:

  • Frailty is a significant predictor of adverse health outcomes, including mortality.
  • Elderly and comorbid populations are increasingly undergoing primary prevention implantable cardioverter defibrillator (ICD) procedures.
  • Limited data exists on the impact of frailty on outcomes following ICD implantation.

Purpose of the Study:

  • To investigate the association between frailty and post-implantation outcomes in patients receiving primary prevention ICDs.
  • To assess the predictive value of the Fried frailty index in this patient cohort.

Main Methods:

  • A prospective cohort study was conducted at a single center.
  • 71 patients undergoing primary prevention ICD insertion were assessed for frailty using the Fried index.
  • Patients were followed for a median of 7.8 years.

Main Results:

  • 17% of patients were identified as frail.
  • Frailty was significantly associated with increased mortality (HR 3.9), ED visits (HR 2.7), and hospitalizations (HR 2.8).
  • No association between Fried frailty scores and adverse outcomes was observed in the non-frail group; frail patients did not receive appropriate shock therapy.

Conclusions:

  • Frailty is a critical factor associated with poorer outcomes, including mortality and morbidity, in primary prevention ICD recipients.
  • Clinicians should incorporate frailty assessment into risk-benefit discussions for this patient group.
Abstract

Keywords:
CRTCVDICDSCDcardiac resynchronization therapycardiovascular diseasefrailty assessmentimplantable cardioverter defibrillatorprimary preventionsudden cardiac death

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