Impact of Frailty on In-Hospital Outcomes in Patients Undergoing Atrial Fibrillation Ablation

Catheter ablation for atrial fibrillation (AF) has been shown to improve arrhythmia burden and quality of life compared with medical treatment alone. 1 Mark DB Anstrom KJ Sheng S Piccini JP Baloch KN Monahan KH Daniels MR Bahnson TD Poole JE Rosenberg Y Lee KL Packer DL CABANA InvestigatorsEffect of catheter ablation vs medical therapy on quality of life among patients with atrial fibrillation: the CABANA randomized clinical trial. JAMA. 2019; 321: 1275-1285 Crossref PubMed Scopus (308) Google Scholar Recently, a subgroup analysis from the CABANA (Catheter ABlation versus ANtiarrhythmic Drug Therapy for Atrial Fibrillation) trial 2 Bahnson TD Giczewska A Mark DB Russo AM Monahan KH Al-Khalidi HR Silverstein AP Poole JE Lee KL Packer DL CABANA InvestigatorsAssociation between age and outcomes of catheter ablation versus medical therapy for atrial fibrillation: results from the CABANA trial. Circulation. 2022; 145: 796-804 Crossref PubMed Scopus (26) Google Scholar indicated that patients <65 years old derive more benefit from ablation than do older adults. Identifying such subpopulations likely to benefit from ablation might inform patient selection, leading to improved outcomes. Frailty constitutes another specific subpopulation of patients who have decreased strength, endurance, and reduced physiologic function, which might increase their vulnerability to adverse outcomes. 3 Kundi H Noseworthy PA Valsdottir LR Shen C Yao X Yeh RW Kramer DB Relation of frailty to outcomes after catheter ablation of atrial fibrillation. Am J Cardiol. 2020; 125: 1317-1323 Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar However, whether patients who are frail are more vulnerable to procedural complications associated with AF ablation remains undefined. We therefore examined the impact of frailty on in-hospital outcomes in patients who underwent AF ablation using a nationally representative real-world cohort of patients.