| Title |
Anticoagulant therapy during cardiovascular implantable electronic device procedures / |
| Authors |
Daubaraitė, Aurelija ; Marinskis, Germanas ; Račkauskas, Gediminas |
| DOI |
10.5114/aic.2023.129207 |
| Full Text |
|
| Is Part of |
Postepy w Kardiologii Interwencyjnej = Advances in interventional cardiology.. Poznań : Termedia Publishing House Ltd.. 2023, vol. 19, no. 2, p. 99-112.. ISSN 1734-9338. eISSN 1897-4295 |
| Keywords [eng] |
cardiac resynchronization therapy ; pacemaker ; implantable cardioverter-defibrillator ; anticoagulation ; device pocket haematoma |
| Abstract [eng] |
Aim: The objective of the study is to systematically evaluate the safety and efficacy of peri-procedural utilization of anticoagulation therapy during cardiovascular implantable electronic device procedures. Material and methods: The review materials were based on comprehensive retrieval of randomized controlled trials and observational studies published until April 2023. Studies which compared different management strategies of long-term anticoagulation therapy during peri-procedural cardiac rhythm device implantation and compared the complications of bleeding and/or thromboembolic events were selected and reviewed. Results: Studies analysing non-vitamin K oral anticoagulants interruption versus continuation during peri-procedural implantable cardiac device surgery found no statistically significant difference in bleeding or thromboembolic complications between these strategies. Studies comparing non-vitamin K oral anticoagulants with vitamin K antagonists also showed no statistically significant difference. One study comparing uninterrupted warfarin with interrupted warfarin with heparin bridging reported a reduced incidence of clinically significant device pocket haematoma in patients with continued warfarin treatment (relative risk = 0.19; 95% confidence interval: 0.10 to 0.36; p < 0.001). A sub-analysis of one study comparing dabigatran versus warfarin with heparin bridging and without bridging reported a lower risk of pocket haematoma with dabigatran when compared to warfarin with heparin bridging (risk difference: –8.62%, 95% confidence interval: –24.15 to –0.51%; p = 0.034). Both bleeding and thromboembolic complications were rare. Conclusions: The traditional method of vitamin K antagonists interruption with heparin bridging is less safe than continuing vitamin K antagonists at therapeutic levels. Both continuation and interruption strategies of non-vitamin K anticoagulants during cardiac device surgery seem to be safe and appropriate. |
| Published |
Poznań : Termedia Publishing House Ltd |
| Type |
Journal article |
| Language |
English |
| Publication date |
2023 |
| CC license |
|
