Frailty syndrome in patients with heart rhythm disorders

Młynarska, Agnieszka; Młynarski, Rafal; Gołba, Krzysztof S.

doi:10.1111/ggi.12868

Cited by 11 publications

(14 citation statements)

References 24 publications

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“…AF is a common arrhythmia in elderly patients whereas old age and underlying disease in this patient group are associated with a greater mortality and risk of other complications. 20,[26][27][28] In our study, the mean age was 69.8 years, similar to other published studies. 20,[26][27][28][29] On the other hand, old age and AF increase the risk of frailty and significantly contribute to decreased physical and cognitive capabilities.…”

Section: Discussionsupporting

confidence: 91%

“… 20 , 26 – 28 In our study, the mean age was 69.8 years, similar to other published studies. 20 , 26 - 29 On the other hand, old age and AF increase the risk of frailty and significantly contribute to decreased physical and cognitive capabilities. 30 …”

Section: Discussionsupporting

confidence: 90%

“…22 In a study by Młynarska et al, there was also a strong significant correlation between EHRA score and FS severity. 26 In the study by Wojaszel et al, AF was related to significantly higher scores of FS, independently from age, gender, multimorbidity, and polypharmacy. 31 In our study, the regression analysis identified FS as a statistically significant independent predictor of increased arrhythmia symptom severity in ASTA II and decreased QoL in ASTA III.…”

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 89%

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Quality of Life and Frailty Syndrome in Patients with Atrial Fibrillation

Sławuta¹,

Polański²,

Mazur³

et al. 2020

CIA

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Introduction: Atrial fibrillation (AF) and frailty syndrome (FS) are a part of the aging process. Both are still of great importance in the assessment of quality of life (QoL). There is definitely a lack of research clarifying the association between FS and QoL in AF patients. Objective: The aim of this study was to evaluate the influence of FS on QoL in AF patients. Materials and Methods: The retrospective and observational study included 158 inpatients with mean age 69.8±7.1 years, treated for AF in the cardiac department from 1 April 2019 to 31 June 2019. The following instruments were used: the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) and the Edmonton Frail Scale (EFS). Results: The mean level of frailty in the study group was 8.5±5.0. In 25.9% of patients, the level of frailty was mild, in 10.1% moderate, and in 17.1% severe. Patients were divided into two groups based on their frailty status. In comparative analysis of the QoL, there were significant differences between the groups: the frail group had more intense symptoms of arrhythmia than the non-frail group (14.9±4.1 vs 11.9±4.9; p<0.001). In the analysis of the total score impact of arrhythmia on QoL, the frail group had a significantly higher score than the non-frail group (23.5±5.2 vs 14.5±5.5), which confirmed the stronger negative impact of arrhythmia on QoL. In the regression coefficient analysis, the independent predictor of symptom severity and QoL was FS. However, we observed a negative impact of diabetes, which increased the impact of arrhythmia on QoL, and physical activity, which improved QoL and decreased the impact of symptoms on everyday life. Conclusion: Patients in the frail group have worse QoL and higher impact of arrhythmia on QoL in comparison to patients in the non-frail group. Frailty is an independent predictor of higher intensity of symptoms of arrhythmia and worse QoL. Diabetes and physical activity are predictors of QoL for patients with AF.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 89%

See 2 more Smart Citations

Quality of Life and Frailty Syndrome in Patients with Atrial Fibrillation

Sławuta¹,

Polański²,

Mazur³

et al. 2020

CIA

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“…Frailty syndrome is a state of increased susceptibility to endogenous and exogenous stress factors, which result from reduced physiological reserves and the dysfunction of many of the systems that affect homeostasis and the stress response. 15,16 The literature reports that frailty syndrome is diagnosed in 4.4% to 75.4% of patients with atrial fibrillation. Polidoro et al showed that frailty is an independent factor that is associated with prevalent AF (AF: 89% frail vs no AF: 67% frail).…”

Section: Discussionmentioning

confidence: 99%

Modified Frailty as a Novel Factor in Predicting the Maintenance of the Sinus Rhythm After Electrical Cardioversion of Atrial Fibrillation in the Elderly Population

Młynarska¹,

Młynarski²,

Marcisz³

et al. 2020

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Introduction: Frailty is a common geriatric syndrome that causes an elevated risk of catastrophic declines in the health and function among older adultswe hypothesized that frailty may be related to the maintenance of sinus rhythm after cardioversion. Methods: The study sample was a group of 199 consecutive patients over 60 (average age 71.41 ± 6.99; 40.2% women) with AF who were hospitalized in order to perform electrical cardioversion. The Tilburg Frailty Indicator (TFI) was used to assess frailty before cardioversion. The six-month visit after the electrical cardioversion was a follow-up. The follow-up period for the maintenance of sinus rhythm after electrical cardioversion was 180 ± 14 days. Results: Patients in whom cardioversion was effective had a statistically significantly lower severity of frailty syndrome (3.44 ± 1.83 vs 5.87 ± 1.12; p=0.000) and its components: physical components (2.14 ± 1.33 vs 3.62 ± 1.05 p=0.000); emotional components (0.92 ± 0.79 vs 1.29 ± 0.86 p=0.037) and social components (0.37 ± 0.56 vs 0.96 ± 0.46; p=0.000) compared to those patients in which cardioversion was ineffective. In the logistic regression, frailty (OR: 0.65, 95% CI:0.5010-0.8330; p=0.000) was observed to be an independent predictor for maintaining sinus rhythm. Conclusion: Frailty is a novel, independent factor that can be used to predict the effectiveness of electrical cardioversion and the maintenance of sinus rhythm in the elderly population. Modifying the level of recognition in the Tilburg Frailty Indicator to a 4 improved the prediction of the effectiveness of electrical cardioversion as well as the maintenance of sinus rhythm.

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Physical frailty, genetic predisposition, and incident arrhythmias

Zhang,

Liu,

et al. 2024

J cachexia sarcopenia muscle

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BackgroundCross‐sectional evidence suggests a possible link between frailty and atrial fibrillation (AF). It remains unclear whether frailty and incident arrhythmias are longitudinally associated. This study aimed to determine whether the frailty phenotype is longitudinally associated with incident arrhythmias, especially AF.MethodsIn this prospective cohort of UK Biobank, individuals with arrhythmias at baseline, those without data for frailty phenotype, and no genetic data were excluded. Five domains of physical frailty, including weight loss, exhaustion, low physical activity, low grip strength, and slow gait speed, were assessed. A total of 142 single‐nucleotide polymorphisms was used to calculate the polygenic risk score (PRS) for AF. Hospital inpatient records and death records were used to identify incident arrhythmias.ResultsThis study included 464 154 middle‐aged and older adults (mean age 56.4 ± 8.1 years, 54.7% female) without arrhythmia at baseline. During a median follow‐up of 13.4 years (over 5.9 million person‐years), 46 454 new‐onset arrhythmias cases were recorded. In comparison with non‐frailty, the multivariable‐adjusted hazard ratios (HRs) of AF were 1.12 (95% CI: 1.09, 1.15, P < 0.0001) and 1.44 (95% CI: 1.36, 1.51, P < 0.0001) for participants with pre‐frailty and frailty, respectively. Similar associations were observed for other arrhythmias. We found that slow gait speed presented the strongest risk factor in predicting all arrhythmias, including AF (HR 1.34, 95% CI: 1.30, 1.39), bradyarrhythmias (HR 1.30, 95% CI: 1.22, 1.37), conduction system diseases (HR 1.29, 95% CI: 1.22, 1.36), supraventricular arrhythmias (HR 1.32, 95% CI: 1.19, 1.47), and ventricular arrhythmias (HR 1.37, 95% CI: 1.25, 1.51), with all P values <0.0001. In addition to slow gait speed, weight loss (HR 1.13, 95% CI: 1.09, 1.16, P < 0.0001) and exhaustion (HR 1.11, 95% CI: 1.07, 1.14, P < 0.0001) were significantly associated with incident AF, whereas insignificant associations were observed for physical activity (HR 1.03, 95% CI: 0.996, 1.08, P = 0.099) and low grip strength (HR 1.00, 95% CI: 0.97, 1.03, P = 0.89). We observed a significant interaction between genetic predisposition and frailty on incident AF (P for interaction <0.0001), where those with frailty and the highest tertile of PRS had the highest risk of AF (HR 3.34, 95% CI: 3.08, 3.61, P < 0.0001) compared with those with non‐frailty and the lowest tertile of PRS.ConclusionsPhysical pre‐frailty and frailty were significantly and independently associated with incident arrhythmias. Although direct causal inference still needs to be further validated, these results suggested the importance of assessing and managing frailty for arrhythmia prevention.

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Frailty syndrome in patients with heart rhythm disorders

Cited by 11 publications

References 24 publications

<p>Quality of Life and Frailty Syndrome in Patients with Atrial Fibrillation</p>

<p>Quality of Life and Frailty Syndrome in Patients with Atrial Fibrillation</p>

<p>Modified Frailty as a Novel Factor in Predicting the Maintenance of the Sinus Rhythm After Electrical Cardioversion of Atrial Fibrillation in the Elderly Population</p>

Physical frailty, genetic predisposition, and incident arrhythmias

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