Impact of Frailty on Recurrence After Catheter Ablation for Atrial Fibrillation: A Systematic Review and Meta-analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
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.
Authors: MUSTAFA BILAL, MEHMET ESAD, SERHAT, FIRAT
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223150908