Dual Antiplatelet Therapy and Heparin “Bridging” Significantly Increase the Risk of Bleeding Complications After Pacemaker or Implantable Cardioverter-Defibrillator Device Implantation

Tompkins, Christine; Cheng, Alan; Dalal, Darshan; Brinker, Jeffrey A.; Leng, Charles T.; Marine, Joseph E.; Nazarian, Saman; Spragg, David D.; Sinha, Sunil K.; Halperin, Henry R.; Tomaselli, Gordon F.; Berger, Ronald D.; Calkins, Hugh; Henrikson, Charles A.

doi:10.1016/j.jacc.2009.12.056

Cited by 139 publications

(102 citation statements)

References 22 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, a previous study found a similar prevalence of CD (56%) among PMPs in a neighbor Brazilian state [7]. Chagas' cardiomyopathy is characterized by HF, sudden death, arrhythmias, and thromboembolic events [3]. Although we observed a significantly increased CV mortality rate among PMPs with CD, after adjustment for the presence of HF symptoms, there was no difference in CV mortality.…”

Section: Recorded Parameterssupporting

confidence: 45%

“…The state of Goias, in central Brazil, has a CD prevalence higher than national average [3,6]. Furthermore, most of our patients lived in rural areas since an early age and were subsequently exposed to the CD vector.…”

Section: Recorded Parametersmentioning

confidence: 88%

“…The rate of PPM infection has been out of proportion to that of device placement [2], and this infection is associated with substantial morbidity, mortality, and financial cost [3,[4][5]. The estimated cost of the combined medical and surgical treatment of an infected, pacemakerdefibrillator system in the United States was ∼$35,000 [6].…”

Section: Risk Factor Of Permanentmentioning

confidence: 99%

“…Based on single-center studies or national registries it seems that both short-and long-term outcomes of ASA are acceptable [2]. The most frequent major complication associated with ASA is the mostly selfterminating complete heart block (CHB) that occurs in 20-50% of patients and requires permanent pacemaker implantation in 9-20% of all ASA patients [2,3]. Accordingly, this retrospective study was undertaken to evaluate the long-term outcome of patients who underwent early permanent pacemaker implantation due to post-ASA CHB.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pacemaker Patients with High Level of Risk

Sabr¹

2016

International Journal of Innovative Research in Electrical, Ele

View full text Add to dashboard Cite

Abstract:In this paper, Cardiac pacing is a safe and effective therapy for multiple bradyarrhythmic conditions [1]. However, incorrect perceptions about the safety of daily activities (SODA) may impair patients' absolute well-being [2]. Chagas' disease (CD) is a chronic protozoan infection caused by Trypanosoma cruzi. Cardiac compromise occurs in up to 30% of CD patients and can manifest as severe bradyarrhythmias. erforated ICD leads were 7F in six of seven ICD patients, whereas only one 9F ICD was represented in our series. The majority of perforated electrodes were active fixation screw in leads.

show abstract

Section: Recorded Parameterssupporting

confidence: 45%

Section: Recorded Parametersmentioning

confidence: 88%

Section: Risk Factor Of Permanentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pacemaker Patients with High Level of Risk

Sabr¹

2016

International Journal of Innovative Research in Electrical, Ele

View full text Add to dashboard Cite

show abstract

“…Tompkins et al reported that dual antiplatelet therapy in patients undergoing pacemaker implantation significantly increased frequency and severity of hemorrhagic complications, compared with the use of aspirin alone [29]. Other authors found no increased risk of bleeding complication in patients receiving clopidogrel or DAPT [30,31].…”

Section: Antithrombotic Therapy In Patients Undergoing Cardiac Rhythmmentioning

confidence: 99%

Management of Anticoagulation Around Cardiac Implantable Electronic Device Surgery

́Anna¹,

Leirira²,

́Anna³

et al. 2016

Anticoagulation Therapy

View full text Add to dashboard Cite

The number of patients requiring cardiovascular implantable electronic device (CIED, e.g., pacemaker and defibrillator) surgery is increasing rapidly and at least a quarter of them are using chronic oral anticoagulation (OAC). Recently, the traditional approach of withholding anticoagulation and using heparin bridging has been challenged by studies showing safety of performing CIED surgery under anticoagulation with vitamin K antagonists. Bridging with heparin is associated with incremental healthcare costs, prolonged hospital admission, and also with an augmented relative risk of pocket hematoma. The risk of embolic events seems to be low and similar with the use of two strategies (heparin bridging and continuous warfarin). Experience with novel oral anticoagulants is limited. Few studies suggest that withholding 48-72 hours before surgery and performing the procedure under anticoagulation are safe alternatives. However, larger randomized clinical trials are needed before definitive conclusions. In this chapter, we review the management of anticoagulation around cardiac implantable electronic device surgery under new conditions.

show abstract