OBJECTIVE: To study incidence of hemorrhagic complications after pacemaker implantation in elderly patients receiving antithrombotic therapy with warfarin or uninterrupted dabigatran. METHODS: 126 patients aged 83 [82; 85] years who receive continuous antithrombotic therapy after pacemaker implantation, were enrolled in the study. Adverse event data were collected during hospitalization and further 12 weeks. RESULTS: 95 subjects (75.4%) from general number of enrolled patients received elective anticoagulant warfarin therapy and 31 subjects (24.6%) were treated with dabigatran. All patients of dabigatran group received 220 mg/day skipping the last dose before a surgery and resumed the drug intake in 36-48 hours after it. Patients of warfarin group underwent surgery if INR was NMT 3; they didn't stop taking the drug for the duration of operation.No statistically significant differences of hematoma incidence were detected in dabigatran (incidence is 0.065, 95%CI (-0.02-0.15)) and warfarin (incidence is 0.05, 95%CI (0.006-0.01)) groups, p(Fisher)= 0.55. Three cases of nonfatal gastrointestinal bleeding (warfarin group) and 1 similar event in dabigatran group were detected during a follow-up (12 [6; 20] weeks): RR= 0.98 (warfarin group), p(Fisher)=0.68. No statistically significant difference of age, sex composition, history of IHD and diabetes was detected between groups by comparison of individual characteristics of patients whose surgeries were complicated/non-complicated by hematoma formation. Upon that, hematoma formation rate was significantly higher in patients with adjunctive pacemaker muscular fixation: 71.4% vs 31.9% (patients without hematomas), p(Fisher)= 0.045. CONCLUSION: Incidence of hematoma formation after pacemaker implantation in patients > 75 years receiving warfarin or dabigatran, is the same as in general population of patients treated with anticoagulants. Adjunctive pacemaker muscular fixation is a significant risk factor of hematoma formation.
OBJECTIVE: To study incidence of hemorrhagic complications after pacemaker implantation in elderly patients receiving antithrombotic therapy with warfarin or uninterrupted dabigatran. METHODS: 126 patients aged 83 [82; 85] years who receive continuous antithrombotic therapy after pacemaker implantation, were enrolled in the study. Adverse event data were collected during hospitalization and further 12 weeks. RESULTS: 95 subjects (75.4%) from general number of enrolled patients received elective anticoagulant warfarin therapy and 31 subjects (24.6%) were treated with dabigatran. All patients of dabigatran group received 220 mg/day skipping the last dose before a surgery and resumed the drug intake in 36-48 hours after it. Patients of warfarin group underwent surgery if INR was NMT 3; they didn't stop taking the drug for the duration of operation.No statistically significant differences of hematoma incidence were detected in dabigatran (incidence is 0.065, 95%CI (-0.02-0.15)) and warfarin (incidence is 0.05, 95%CI (0.006-0.01)) groups, p(Fisher)= 0.55. Three cases of nonfatal gastrointestinal bleeding (warfarin group) and 1 similar event in dabigatran group were detected during a follow-up (12 [6; 20] weeks): RR= 0.98 (warfarin group), p(Fisher)=0.68. No statistically significant difference of age, sex composition, history of IHD and diabetes was detected between groups by comparison of individual characteristics of patients whose surgeries were complicated/non-complicated by hematoma formation. Upon that, hematoma formation rate was significantly higher in patients with adjunctive pacemaker muscular fixation: 71.4% vs 31.9% (patients without hematomas), p(Fisher)= 0.045. CONCLUSION: Incidence of hematoma formation after pacemaker implantation in patients > 75 years receiving warfarin or dabigatran, is the same as in general population of patients treated with anticoagulants. Adjunctive pacemaker muscular fixation is a significant risk factor of hematoma formation.
Authors: Kenneth A Ellenbogen; Anne S Hellkamp; Bruce L Wilkoff; Jorge L Camunãs; John C Love; Tom A Hadjis; Kerry L Lee; Gervasio A Lamas Journal: Am J Cardiol Date: 2003-09-15 Impact factor: 2.778
Authors: Arnold J Greenspon; Jasmine D Patel; Edmund Lau; Jorge A Ochoa; Daniel R Frisch; Reginald T Ho; Behzad B Pavri; Steven M Kurtz Journal: J Am Coll Cardiol Date: 2012-09-19 Impact factor: 24.094
Authors: Uwe K H Wiegand; Dominik LeJeune; Frank Boguschewski; Hendrik Bonnemeier; Frank Eberhardt; Heribert Schunkert; Frank Bode Journal: Chest Date: 2004-10 Impact factor: 9.410
Authors: Boris Schmidt; Michael Brunner; Manfred Olschewski; Christine Hummel; Thomas S Faber; Andreas Grom; Ulrich Giesler; Christoph Bode; Manfred Zehender Journal: Am Heart J Date: 2003-11 Impact factor: 4.749
Authors: J W M van Eck; N M van Hemel; P Zuithof; J P M van Asseldonk; T L H M Voskuil; D E Grobbee; K G M Moons Journal: Europace Date: 2007-06-07 Impact factor: 5.214
Authors: Shivanshu Madan; Purushothaman Muthusamy; Katie L Mowers; Darryl A Elmouchi; Bohuslav Finta; Andre J Gauri; Alan K Woelfel; Timothy D Fritz; Alan T Davis; Nagib T Chalfoun Journal: Cardiovasc Diagn Ther Date: 2016-02