EHRA expert consensus document on the management of arrhythmias in frailty syndrome, endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA). Issue 4 (15th April 2023)

• Record Type: Journal Article
• Authors: Savelieva, Irina; Fumagalli, Stefano; Kenny, Rose Anne; Anker, Stefan; Benetos, Athanase; Boriani, Giuseppe; Bunch, Jared; Dagres, Nikolaos; Dubner, Sergio; Fauchier, Laurent; Ferrucci, Luigi; Israel, Carsten; Kamel, Hooman; Lane, Deirdre A; Lip, Gregory Y H; Marchionni, Niccolò; Obel, Israel; Okumura, Ken; Olshansky, Brian; Potpara, Tatjana; Stiles, Martin K; Tamargo, Juan; Ungar, Andrea; Kosiuk, Jedrzej; Larsen, Torben Bjerregaard; Dinov, Borislav; Estner, Heidi; Garcia, Rodrigue; Moscoso Costa, Francisco Manuel; Lampert, Rachel; Lin, Yenn-Jiang; Chin, Ashley; Rodriguez, Heliodoro Antonio; Strandberg, Timo; Grodzicki, Tomasz;
• Is Part Of: Europace. Volume 25:Issue 4(2023)
• Page Start: 1249
• Page End: 1276
• Publication Date: 2023-04-15
• Subjects: European Heart Rhythm Association -- Position paper -- Consensus document -- Frailty -- Elderly -- Frailty syndrome -- Frailty assessment -- Frailty domains -- Pre-frailty state -- Elderly -- Cachexia -- Arrhythmias -- Atrial fibrillation -- Ventricular tachycardia -- Heart failure -- Stroke -- Cognitive impairment -- Antiarrhythmic drugs -- Anticoagulants -- Ablation -- Pacemaker -- Implantable cardioverter-defibrillator -- Cardiac resynchronization therapy -- Cardiac resynchronization therapy-defibrillator; Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/euac123
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract: There is an increasing proportion of the general population surviving to old age with significant chronic disease, multi-morbidity, and disability. The prevalence of pre-frail state and frailty syndrome increases exponentially with advancing age and is associated with greater morbidity, disability, hospitalization, institutionalization, mortality, and health care resource use. Frailty represents a global problem, making early identification, evaluation, and treatment to prevent the cascade of events leading from functional decline to disability and death, one of the challenges of geriatric and general medicine. Cardiac arrhythmias are common in advancing age, chronic illness, and frailty and include a broad spectrum of rhythm and conduction abnormalities. However, no systematic studies or recommendations on the management of arrhythmias are available specifically for the elderly and frail population, and the uptake of many effective antiarrhythmic therapies in these patients remains the slowest. This European Heart Rhythm Association (EHRA) consensus document focuses on the biology of frailty, common comorbidities, and methods of assessing frailty, in respect to a specific issue of arrhythmias and conduction disease, provide evidence base advice on the management of arrhythmias in patients with frailty syndrome, and identifies knowledge gaps and directions for future research.