Impact of frailty on outcomes after ventricular tachycardia ablation: A prospective observational study.

BACKGROUND

Ablation is an important treatment modality for ventricular tachycardia (VT). With the growing older population, frailty is a rising concern for ablation procedures. This study investigated the prognostic significance of frailty parameters in patients undergoing VT ablation.

METHODS

The patients with ventricular arrhythmias due to ischemic cardiomyopathy, non-ischemic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and R-on-T phenomenon were included. Frailty was assessed using the Clinical Frailty Scale (CFS), Timed Up and Go (TUG), four-meter walking speed, and Tilburg Frailty Indicator (TFI). A 12-month follow-up was performed for survival and VT recurrence.

RESULTS

A total of 50 patients were prospectively included in the study. The mean age was 58.3 ± 13.8 years, and 90% were male. 26 patients (52%) died or were hospitalized for VT recurrence during 12-month follow-up. Worse outcomes were associated with a slower four-meter walking speed (p = 0.043), longer TUG (p = 0.042), and higher CFS (p = 0.047). No significant difference was found in TFI values. On Cox analysis, frailty was associated with post-VT ablation mortality (CFS hazard ratio [HR] = 1.676, 95% confidence interval [CI] = 1.141–2.464; p = 0.009, TUG HR = 1.041, 95% CI = 1.018–1.065; p = 0.001, four-meter gait speed HR = 0.17, 95% CI = 0.041–0.708; p = 0.015). ROC analysis revealed that the AUC was 0.732 for the TUG test and 0.739 for the 4-m walk test. Kaplan–Meier survival analysis demonstrated that increasing frailty was associated with higher all-cause mortality.

CONCLUSION

Frailty was found to be associated with increased mortality and recurrence following VT ablation. Future prospective studies with large patient cohort should validate these findings and explore role of frailty in this population.