Device-Pocket Hematoma after Cardiac Implantable Electronic Devices

Notaristefano, Francesco; Angeli, Fabio; Verdecchia, Paolo; Zingarini, Gianluca; Spighi, Lorenzo; Annunziata, Roberto; Reccia, Matteo Rocco; Piraccini, S; Notaristefano, Salvatore; Lip, Gregory Y.H.; Cavallini, Claudio

doi:10.1161/circep.120.008372

Cited by 6 publications

(15 citation statements)

References 3 publications

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“…Pocket hematoma is a major complication after CIED implantations, and it increases the risk of device-related infections ( 6 , 19 ). In this prospective randomized trial, the efficacy of the proposed novel compression device was evaluated and compared with conventional techniques in patients undergoing electronic device implantations.…”

Section: Discussionmentioning

confidence: 99%

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Effect of a Novel Pocket Compression Device on Hematomas Following Cardiac Electronic Device Implantation in Patients Receiving Direct Oral Anticoagulants

Fei

Wang

Zhu

et al. 2022

Front. Cardiovasc. Med.

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BackgroundA pocket hematoma is a well-recognized complication that occurs after pacemaker or defibrillator implantation. It is associated with increased pocket infection and hospital stay. Patients suffering from atrial fibrillation and undergoing cardiovascular electronic implantable device (CIED) surgery are widely prescribed and treated with direct oral anticoagulants (DOACs). In this study, the use of a novel compression device was evaluated to examine its ability to decrease the incidence of pocket hematomas following device implantation with uninterrupted DOACs.MethodsA total of 204 participants who received DOACs and underwent CIED implantation were randomized into an experimental group (novel compression device) and a control group (elastic adhesive tape with a sandbag). The primary outcome was pocket hematoma, and the secondary outcomes were skin erosions and patient comfort score. Grade 3 hematoma was defined as a hematoma that required anticoagulation therapy interruption, re-operation, or prolonged hospital stay.ResultsThe baseline characteristics of both groups had no significant differences. The incidence of grades 1 and 2 hematomas was significantly lower in the compression device group than in the conventional pressure dressing group (7.8 vs. 23.5 and 2.0 vs. 5.9%, respectively; P < 0.01). Grade 3 hematoma occurred in 2 of 102 patients in the experimental group and 7 of 102 patients in the control group (2.0 vs. 6.9%; P = 0.03). The incidence rates of skin erosion were significantly lower, and the patient comfort score was much higher in the compression device group than in the control group (P < 0.01). Multivariable logistic regression analysis showed that the use of novel compression device was a significant protective factor for pocket hematoma (OR = 0.42; 95% CI, 0.29–0.69, P = 0.01).ConclusionsThe incidence of pocket hematomas and skin erosions significantly decreases when the proposed compression device is used for patients undergoing device implantation with uninterrupted DOACs. Thus, the length of hospital stay and re-operation rate can be reduced, and patient comfort can be improved.Clinical Trial Registrationhttp://www.chictr.org.cn, identifier: ChiCTR2100049430.

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Section: Discussionmentioning

confidence: 99%

“…A well-recognized complication associated with these procedures is pocket hematoma, which is reported in 2-9% of patients. Patients on antithrombotic therapy have an increased risk of having pocket hematoma (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Effect of a Novel Pocket Compression Device on Hematomas Following Cardiac Electronic Device Implantation in Patients Receiving Direct Oral Anticoagulants

Fei

Wang

Zhu

et al. 2022

Front. Cardiovasc. Med.

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“…Pocket hematomas during device implantation, a relatively common complication, are associated with an increased risk of device infection (7). It has been reported that the use of a post-surgical vest effectively suppresses the formation of hematomas (2).…”

Section: Discussionmentioning

confidence: 99%

Effective Use of Keishibukuryogan in Subcutaneous Hematoma after Implantable Cardiac Device Surgery in Two Cases

et al. 2021

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Keishibukuryogan is a Kampo medicine that induces vasodilation and improves the blood flow velocity in subcutaneous blood vessels. We herein report two cases in which keishibukuryogan completely diminished subcutaneous hematoma after cardiac resynchronization therapy pacemaker implantation and defibrillator battery replacement within a month. Keishibukuryogan can be a good option for treating or preventing subcutaneous hematoma after surgical procedures for devices.

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“…The pocket hematoma (PH), a common complication of pacemaker implantations, is detected in 2%-7% of cases [1,2]. PH is clinically manifested by a sensation of local discomfort and pain and is associated with infiltration of the subcutaneous tissue [3].…”

Section: Introductionmentioning

confidence: 99%

“…PH is clinically manifested by a sensation of local discomfort and pain and is associated with infiltration of the subcutaneous tissue [3]. Furthermore, this complication may require surgical intervention [2], which increases the risk of infection of the endocardial system [4] and prolongs hospitalization [5]. Hence, the search for ways to prevent bleeding from the pacemaker pocket is of great practical interest.…”

Section: Introductionmentioning

confidence: 99%

Application of Hemostatic Agent “Haemoblock” for Pocket Hematoma Reduction. Design of the PEGAS study: a Multicenter Clinical Trial

Нечепуренко

Ilov²,

Дурманов

et al. 2021

Cardiac Arrhythmias

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Pocket hematoma (PH) is a common complication of pacemaker implantations which prolongs hospitalization and may demand surgical revision in some cases. According to the data from different researchers PH rate varies from 2 to 7%. It depends on number of factors including a need for anticoagulation therapy. We present a review of design of multicenter clinical trial evaluating safety and efficacy of application of hemostatic agent Haemoblock for pocket hematoma reduction in patients taking oral anticoagulants.

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Device-Pocket Hematoma after Cardiac Implantable Electronic Devices

Cited by 6 publications

References 3 publications

Effect of a Novel Pocket Compression Device on Hematomas Following Cardiac Electronic Device Implantation in Patients Receiving Direct Oral Anticoagulants

Effect of a Novel Pocket Compression Device on Hematomas Following Cardiac Electronic Device Implantation in Patients Receiving Direct Oral Anticoagulants

Effective Use of Keishibukuryogan in Subcutaneous Hematoma after Implantable Cardiac Device Surgery in Two Cases

Application of Hemostatic Agent “Haemoblock” for Pocket Hematoma Reduction. Design of the PEGAS study: a Multicenter Clinical Trial

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