SynthesisJournal of general internal medicine2019
Frailty, Implantable Cardioverter Defibrillators, and Mortality: a Systematic Review.
Synthesis in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Association between frailty and adverse outcomes after cardiac resynchronization therapy: a systematic review and meta-analysis.European geriatric medicine · 2025Pooled it
- JCS/JHRS 2024 Guideline Focused Update on Management of Cardiac Arrhythmias.Journal of arrhythmia · 2025Article
- Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2025Article
- Implantable cardiac defibrillator outcomes in octogenarians.Journal of arrhythmia · 2025Article
- Aligning goals with care: Advance directives in older adults with implantable cardioverter-defibrillators.Pacing and clinical electrophysiology : PACE · 2024Article
- Reply: How well can frailty predict no benefit from ICD therapy?Clinical cardiology · 2024Article
- Review
- The concurrent impact of mild cognitive impairment and frailty syndrome in heart failure.Archives of medical science : AMS · 2023Article
- Can the Norton Scale Score Be Used as an Adjunct Tool for Implantable Defibrillator Patient Selection? A Retrospective Single-Center Cohort Study.Journal of clinical medicine · 2022Article
- Assessment Tools of Biopsychosocial Frailty Dimensions in Community-Dwelling Older Adults: A Narrative Review.International journal of environmental research and public health · 2022Review
- Frailty Syndrome in Older Adults with Cardiovascular Diseases-What Do We Know and What Requires Further Research?International journal of environmental research and public health · 2022Review
- The Association Between Cardiometabolic Risk Factors and Frailty in Older Adults: A Systematic Review.Innovation in aging · 2022Review
- The Relationship between Frailty Syndrome and Concerns about an Implantable Cardioverter Defibrillator.International journal of environmental research and public health · 2020Article
- Perspectives on Implementing a Multidomain Approach to Caring for Older Adults With Heart Failure.Journal of the American Geriatrics Society · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundEvidence for the benefit of implantable cardioverter defibrillators (ICD) in preventing sudden cardiac death (SCD) in older adults is mixed; age alone may not predict benefit. Frailty may help identify patients in whom an ICD does not improve overall mortality risk.
methodsStructured search of PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials on 1/31/2019, without language restriction, with terms for ICD, frailty, and mortality. Frailty was defined broadly using any validated single component (e.g., walking speed, weight loss) or multi-component tool (e.g., cumulative deficit index). Each study was assessed for quality and risk of bias.
resultsWe identified and screened 2649 titles, reviewed 280 abstracts, and extracted 71 articles. Nine articles, including two RCTs, one prospective cohort, and six retrospective cohort studies met all criteria. The most common reason for exclusion was a lack of frailty definition. Frailty definitions were heterogeneous, including cumulative deficit models, low weight, and walking speed. Follow-up time for mortality differed: from days to > 6 years. All studies indicated that mortality was higher amongst individuals identified as frail, regardless of definition. In one RCT, slow walkers did not benefit from ICD therapy after 3 years. A cohort of 83,792 Medicare beneficiaries in an ICD registry reported higher 1-year mortality following ICD in those with frailty or dementia. Four studies reported an association between being underweight and increased mortality following ICD placement.
conclusionExisting literature suggests that individuals with frailty may not benefit from ICD placement for primary prevention of SCD.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.