Abstract

Background: Frailty interferes both the management and the prognosis of atrial fibrillation (AF) in elderly patients. Catheter ablation (CA) is an important treatment for AF, but its safety for AF treatment among the elderly patients with frailty remains poorly studied. We thus aimed to investigate the prevalence of frailty among the elderly AF patients undergoing CA and to explore the association of frailty with adverse outcomes following CA.

Methods: A total of 1,134 elderly patients (aged ≥ 65 years) who underwent CA for AF in Guangdong Provincial People's Hospital fromJanuary 2015 to December 2019were included. Subjectswere divided into non-frail and frail groups according to the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS) at admission. The in-hospital outcomes and their clinical data were analyzed.

Results: Frailty occurred in 19.3% of the included participants and the prevalence increased rapidly from 7.8% in 2015 to 34.0% in 2019. None of the patients had all-cause mortality in the hospital after CA. Compared with the non-frail group (n = 915), the frail group (n = 219) had significantly higher incidence of post-operative infection (5.5% vs. 1.9%, p = 0.002). Frailty was still significantly associated with an increased risk for post-operative infection in multivariate-adjusted regression analysis (OR = 2.72, 95% CI = 1.12–6.62, p = 0.027). There was no significantly statistical difference in other outcomes including procedure-related complications and length of stay.

Conclusions: Among the elderly patients with AF, frailty was associated with a higher rate of post-operative infection following CA treatment. However, frailty did not confer a higher mortality risk or more major complications.