Impact of Frailty on Recurrence After Catheter Ablation for Atrial Fibrillation: A Systematic Review and Meta-analysis.
4 affiliations
- 1Department of Medicine, Penn Medicine Princeton Medical Center, Plainsboro, NJ, USA.
- 2Department of Cardiology, Montefiore Medical Center, Bronx, NY, USA.
- 3Department of Medicine, Metropolitan Hospital Center, New York, NY, USA.
- 4Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
Abstract
Frailty is an increasingly recognized marker of biological vulnerability in patients with atrial fibrillation (AF). Although catheter ablation (CA) is an established rhythm-control strategy, atrial tachyarrhythmia (AT) recurrence remains common, particularly in patients with advanced age and comorbidity burden. The impact of frailty on post-ablation recurrence has not been systematically quantified. We systematically searched MEDLINE, EMBASE, and the Cochrane Library for studies evaluating the association between frailty and AT recurrence following CA for AF. Eligible studies compared frail and non-frail adults undergoing CA and reported post-procedural recurrence. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Four studies totaling 1096 patients were included, of whom 266 (24.3%) were frail. Across the included studies, the mean age of participants ranged from approximately 61 to 76 years. Frailty was associated with a significantly higher risk of AT recurrence after CA compared with non-frailty (RR, 1.57; 95% CI, 1.26-1.94; P < .001; I ² = 0%). This association remained significant in subgroup analyses limited to studies with ≤12 months of follow-up (RR, 1.46; 95% CI, 1.13-1.89; P = .004; I ² = 0%). Leave-one-out sensitivity analyses confirmed robustness. In conclusion, frailty is independently associated with increased AT recurrence following CA for AF and should be considered in pre-procedural risk stratification.
Related
- Metabolic Dysfunction-Associated Steatotic Liver Disease and Atrial Fibrillation Recurrence After Catheter Ablation: A Systematic Review and Meta-Analysis
- Bone Morphogenetic Protein-10 as a Predictor of Atrial Fibrillation Recurrence After Catheter Ablation: A Systematic Review and Meta-Analysis.
- Predictive Value of Left Atrial Strain Combined with Low-Voltage Substrate for Recurrence After Radiofrequency Catheter Ablation in Persistent Atrial Fibrillation
- Impact of atrial fibrillation catheter ablation o'n tricuspid regurgitation severity: a systematic review and meta-analysis.
- Novel cholesterol-high-density lipoprotein-glucose index is associated with 1-year recurrence of atrial fibrillation after catheter ablation
BibTeX
@article{ozbay2026impact,
title = {{Impact of Frailty on Recurrence After Catheter Ablation for Atrial Fibrillation: A Systematic Review and Meta-analysis.}},
author = {Mustafa Bilal Ozbay and Mehmet Esad Demirhan and Serhat Degirmen and Firat Ozcan},
journal = {The Journal of innovations in cardiac rhythm management},
year = {2026},
month = jul,
doi = {10.19102/icrm.2026.17076},
url = {https://europepmc.org/article/MED/42899030},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of Frailty on Recurrence After Catheter Ablation for Atrial Fibrillation: A Systematic Review and Meta-analysis.
AU - Mustafa Bilal Ozbay
AU - Mehmet Esad Demirhan
AU - Serhat Degirmen
AU - Firat Ozcan
PY - 2026
DA - 2026/07/15
JO - The Journal of innovations in cardiac rhythm management
DO - 10.19102/icrm.2026.17076
UR - https://europepmc.org/article/MED/42899030
AB - Frailty is an increasingly recognized marker of biological vulnerability in patients with atrial fibrillation (AF). Although catheter ablation (CA) is an established rhythm-control strategy, atrial tachyarrhythmia (AT) recurrence remains common, particularly in patients with advanced age and comorbidity burden. The impact of frailty on post-ablation recurrence has not been systematically quantified. We systematically searched MEDLINE, EMBASE, and the Cochrane Library for studies evaluating the association between frailty and AT recurrence following CA for AF. Eligible studies compared frail and non-frail adults undergoing CA and reported post-procedural recurrence. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Four studies totaling 1096 patients were included, of whom 266 (24.3%) were frail. Across the included studies, the mean age of participants ranged from approximately 61 to 76 years. Frailty was associated with a significantly higher risk of AT recurrence after CA compared with non-frailty (RR, 1.57; 95% CI, 1.26-1.94; P < .001; I ² = 0%). This association remained significant in subgroup analyses limited to studies with ≤12 months of follow-up (RR, 1.46; 95% CI, 1.13-1.89; P = .004; I ² = 0%). Leave-one-out sensitivity analyses confirmed robustness. In conclusion, frailty is independently associated with increased AT recurrence following CA for AF and should be considered in pre-procedural risk stratification.
SN - 2156-3977
SN - 2156-3993
ER -