Anticoagulation Management in the Perioperative Phase of Implantable Cardioverter Defibrillator Implantation

Yokoshiki, Hisashi; Makino, Hírofumi; Watanabe, Masaya; Matsui, Yoshiro; Tsutsui, Hiroyuki

doi:10.1253/circj.cj-12-1507

Cited by 10 publications

(12 citation statements)

References 35 publications

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“…By screening titles and abstracts, 66 studies were selected. After browsing the full texts for more details, 14 studies qualified for the meta‐analysis according to the predefined inclusion. The characteristics of the studies, including baseline characteristics of the enrolled patients, involved groups, indication for anticoagulation, the types of procedure, and perioperative antiplatelet drugs, were presented in Table .…”

Section: Resultsmentioning

confidence: 99%

Perioperative Anticoagulation Management in Patients on Chronic Oral Anticoagulant Therapy Undergoing Cardiac Devices Implantation: A Meta‐Analysis

Zhang

Wang

et al. 2014

Pacing Clinical Electrophis

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The perioperative anticoagulation strategy during cardiac implantable electronic devices (CIEDs) implantation is highly variable without consensus among implanting physicians. A systematic literature search was performed in MEDLINE, EMBASE, and the Cochrane Library to identify clinical trials in patients on chronic oral anticoagulant (OAC) therapy undergoing CIEDs implantation. Bleeding and thromboembolic events were compared among heparin bridging, continued OAC, and interrupted OAC groups. Data were expressed as relative risks (RRs) and 95% confidence intervals (CIs) using random effects model. According to the inclusion criteria, totally 14 studies involving 3,744 patients were identified and included in the study. The heparin bridging group showed a significantly higher risk of bleeding events (relative risk [RR] 3.10, 95% confidence interval [CI], 2.02-4.76, P< 0.00001), especially pocket hematoma (RR 3.58, 95% CI, 2.17-5.91, P < 0.00001), but no significantly lower incidence of thromboembolism (RR 1.16, 95% CI, 0.36-3.67, P = 0.81) compared with OAC continuation group. Meanwhile, both unfractionated heparin-bridged and low-molecular-weight heparin-bridged subgroup exhibited a higher risk of bleeding. There was no significant difference between OAC continuation and OAC interruption group in bleeding (RR 0.90, 95% CI, 0.65-1.24, P = 0.52) and thromboembolic (RR 0.57, 95% CI, 0.16-2.01, P = 0.38) complications. The OAC interruption group had an obviously lower incidence of bleeding in comparison with the heparin bridging group and no statistical significance was observed in thrombus occurrence. Implantation of CIEDs with continuous OAC therapy may offer the best option by combining the lower risk of bleeding with rare thromboembolism compared with heparin bridging and OAC interruption therapy.

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Section: Resultsmentioning

confidence: 99%

Perioperative Anticoagulation Management in Patients on Chronic Oral Anticoagulant Therapy Undergoing Cardiac Devices Implantation: A Meta‐Analysis

Zhang

Wang

et al. 2014

Pacing Clinical Electrophis

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show abstract

“…Although several measures reduce the risk of VTE, orthopedic surgeons are properly concerned about the potential hemorrhagic effect of pharmacological prophylaxis, which could be the cause of prolonged recovery, wound failure, and even periprosthetic infection. 32, 33 The benefit of using anticoagulants for the prevention of VTE is counterbalanced by the potential risk of bleeding. Thus, an important issue in the prevention of VTE is risk stratification (ie, whether some patients are at greater risk for VTE than others and therefore should receive different doses of anticoagulants or different treatment modalities).…”

Section: Discussionmentioning

confidence: 99%

Utility of Noninvasive Endothelial Function Test for Prediction of Deep Vein Thrombosis After Total Hip or Knee Arthroplasty

Suzuki

Matsuzawa

Konishi

et al. 2014

Circ J

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“…[4][5][6][7] In particular, the data specific to CIED implantation significantly favor continuation of warfarin therapy through the procedure over bridging with heparin. 8, 9 In fact, continuing anticoagulation with warfarin does not increase the risk of hematoma compared with no anticoagulation. Therefore, CIED implantations are performed without interruption of anticoagulation therapy.…”

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confidence: 99%

Novel Compression Tool to Prevent Hematomas and Skin Erosions After Device Implantation

Kiuchi¹,

Okajima²,

Tanaka³

et al. 2015

Circ J

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Anticoagulation Management in the Perioperative Phase of Implantable Cardioverter Defibrillator Implantation

Cited by 10 publications

References 35 publications

Perioperative Anticoagulation Management in Patients on Chronic Oral Anticoagulant Therapy Undergoing Cardiac Devices Implantation: A Meta‐Analysis

Perioperative Anticoagulation Management in Patients on Chronic Oral Anticoagulant Therapy Undergoing Cardiac Devices Implantation: A Meta‐Analysis

Utility of Noninvasive Endothelial Function Test for Prediction of Deep Vein Thrombosis After Total Hip or Knee Arthroplasty

Novel Compression Tool to Prevent Hematomas and Skin Erosions After Device Implantation

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