Frailty in patients undergoing percutaneous left atrial appendage closure: The Frail-LAAC study

doi:10.1016/j.hrthm.2026.01.041

Valvular & structural heart disease

Frailty in patients undergoing percutaneous left atrial appendage closure: The Frail-LAAC study

Heart RhythmPublished 3 Feb 2026international, multicenter, prospective study

Main finding · All-cause mortality or ischemic eventsResultAdjusted hazard ratio 4.85 95% CI 2.85–8.24

Read the original article ↗

Cite

Authors' conclusion

Frailty is common in patients undergoing LAAC and is associated with a 5-fold increased mortality risk. Incorporating frailty assessment into preprocedural evaluations enhanced risk stratification, highlighting the need for careful patient selection, particularly in those with advanced frailty, to optimize outcomes and avoid futile interventions.

Study context

Population: Patients undergoing left atrial appendage closure (LAAC)consecutive patients included, frailty in 101 (22.4%)
Participants: 452 patients

Exposure: frail patients compared to nonfrail patients
frailn = 101

Methodological detailsconsecutive patients, 4 university centers (2022-2024)

Consecutive patients
4 university centers (2022-2024)

Main finding

All-cause mortality or ischemic events · median follow-up of 12 (4-22) months

Adjusted hazard ratio

4.85

95% CI 2.85–8.24

P < 0.001

By group

frail36.6%

nonfrail9.4%

Frail vs nonfrail

adjusted HR 4.85 (95% CI 2.85–8.24); P < 0.001

As reported in the abstract

Observational data: associations, not effects.

Further findings

Outcome	Frail	Nonfrail	Prefrail	Robust	← Lower risk ←→ Higher risk →	Adjusted HR (95% CI)	P value
Mortality · median follow-up of 12 (4-22) months — frail vs nonfrail	33.7%	7.7%	Not reported in the abstract	Not reported in the abstract	0.10.31310	5.28 (2.94–9.46)	P < 0.001	prefrail, robust: not reported in the abstract
Mortality · median follow-up of 12 (4-22) months — prefrail vs robust · prefrailty not associated with mortality					0.10.31310	2.87 (0.83–9.98)	P = 0.115
					0.10.31310Adjusted hazard ratio (log scale)

Device and procedural success

Device success: 99.6%
Procedural success: 97.3%

Frailty in predictive models

Significantly improved mortality risk stratification

Safety

Procedure-related complications

No differences across groups: P = 0.188

Original publication

Frailty in patients undergoing percutaneous left atrial appendage closure: The Frail-LAAC study. Heart Rhythm. Published 3 February 2026. doi:10.1016/j.hrthm.2026.01.041

Read the original article ↗PubMed

Summarised from the published abstract; every number is checked against it