Pocket hematoma after pacemaker or defibrillator surgery: Direct oral anticoagulants versus vitamin K antagonists.

Autor:	de Heide J; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., van der Graaf M; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., Holl MJ; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., Bhagwandien RE; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., Theuns DAMJ; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., de Wit A; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., Zijlstra F; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., Szili-Torok T; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., Lenzen MJ; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., Yap SC; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2022 Mar 16; Vol. 39, pp. 101005. Date of Electronic Publication: 2022 Mar 16 (Print Publication: 2022).
DOI:	10.1016/j.ijcha.2022.101005
Abstrakt:	Background: Direct oral anticoagulants (DOACs) are the preferred choice of oral anticoagulation in patients with atrial fibrillation (AF). Randomized trials have demonstrated the efficacy and safety of DOAC in patients undergoing a cardiac implantable electronic device procedure (CIED); however, there is limited real-world data. Objective: To evaluate the outcome of patients undergoing an elective CIED procedure in a tertiary referral center with an interrupted DOAC or continued vitamin K antagonist (VKA) regimen. Methods: This was a retrospective single-center study of consecutive patients with AF undergoing an elective CIED procedure between January 2016 and June 2019. The primary endpoint was a clinically significant pocket hematoma < 30 days after surgery. The secondary endpoint was any systemic thromboembolic complication < 30 days after surgery. Results: Of a total of 1,033 elective CIED procedures, 283 procedures were performed in patients with AF using oral anticoagulation. One-third of the procedures were performed under DOAC (N = 81, 29%) and the remainder under VKA (N = 202, 71%). The DOAC group was younger, had less chronic renal disease, more paroxysmal AF and a lower HAS-BLED score. The VKA group more often underwent a generator change only in comparison to the DOAC group. Clinically significant pocket hematoma occurred in 5 patients (2.5%) in the VKA group and did not occur in the DOAC group ( P  = 0.33). There were no thromboembolic events reported. Conclusion: In patients with AF undergoing an elective CIED procedure, the risk of a pocket hematoma and a systemic thromboembolic event is comparably low when using either continued VKA or interrupted DOAC. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2022 The Author(s).)
Databáze:	MEDLINE
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