Frailty in patients with atrial fibrillation: diagnosis, management, prevention and influence on prognosis

The review is devoted to frailty in patients with atrial fibrillation (AF). The number of elderly patients with AF is constantly increasing, and this category of patients is characterized by high incidence of stroke and bleeding. Frailty is a key geriatric syndrome. Research of frailty in patients with AF is extremely important, since involutional processes in cardiovascular system, brain, kidneys and gastrointestinal tract cause metabolism of anticoagulants and increase the risk of thromboembolic and hemorrhagic complications. The review highlights the tools, scales and questionnaires for assessing frailty in patients with cardiovascular diseases. In addition, some biomarkers related to frailty syndromes in patients with AF are described. Data on negative impact of frailty on prognosis in patients with AF are presented, and measures to prevent frailty and its progression are outlined. These data indicate the need to introduce geriatric tools into interdisciplinary approach. This can delay loss of working capacity, improve the quality of life and prevent negative outcomes in elderly and senile patients with AF.