Background:Although patients with poor ability to perform activities of daily living, such as those with high Clinical Frailty Score (CFS), will often receive a cardiac implantable electric device (CIED), the indications for implantation in these patients have not been clearly defined. We investigated the association between CFS and prognosis in patients with a CIED.

Methods and Results:We retrospectively enrolled 323 consecutive patients who underwent initial device implantation (age, 77 (70–83) years; male, 181 [56%] patients; high-voltage device, 49 [15%] patients), and the CFS was retrospectively estimated. Primary outcome was all-cause death, and the secondary outcome was hospitalization due to heart failure (HF). Median CFS was 4 (3–5) points. During 2 years’ follow-up, all-cause death occurred in 32 patients (10%). Freedom from all-cause death was significantly lower in patients with a high CFS than in those with a low score (1–2 points: 100%, 3–4 points: 92.9%, 5–9 points: 77.3%, P<0.01). After adjustment for age and sex, the CFS was an independent predictor of the primary outcome (hazard ratio [HR] 2.0, 95% confidence interval [CI] 1.6–2.5, P<0.01), and of the secondary outcome (HR 1.6 [95% CI 1.2–2.0], P<0.01).

Conclusions:The CFS is an independent predictor of both death and hospitalization due to HF in patients with a CIED.

背景：虽然日常生活活动能力较差的患者，如临床虚弱评分（CFS）高的患者，通常会接受心脏植入式电子装置（CIED），但这些患者的植入指征尚未明确. 我们调查了 CFS 与 CIED 患者预后之间的关系。

方法和结果：我们回顾性地纳入了 323 名接受初始装置植入的连续患者（年龄，77（70-83）岁；男性，181 名 [56%] 患者；高压装置，49 名 [15%] 患者），并回顾性估计了 CFS . 主要结果是全因死亡，次要结果是因心力衰竭 (HF) 住院。CFS 中位数为 4 (3–5) 分。在 2 年的随访期间，32 名患者 (10%) 发生了全因死亡。高 CFS 患者的全因死亡自由度显着低于低评分患者（1-2 分：100%，3-4 分：92.9%，5-9 分：77.3%，P<0.01 ). 调整年龄和性别后，CFS 是主要结果（风险比 [HR] 2.0，95% 置信区间 [CI] 1.6–2.5，P<0.01）和次要结果（HR 1.6 [ 95% CI 1.2–2.0]，P<0.01）。

结论： CFS 是 CIED 患者因 HF 死亡和住院的独立预测因子。