Arrhythmias & electrophysiology
Impact of peri-procedural management of direct oral anticoagulants on pocket haematoma after cardiac electronic device implantation: the StimAOD multicentre prospective study
Authors' conclusion
In this large real-life registry where most patients had DOAC interruption, clinically relevant haematoma was rare. Despite DOAC interruption and high CHA2DS2-VASc score, thromboembolic events occurred seldomly, highlighting that bleeding exceeds thromboembolic risk in this peri-procedural period.
Study context
- Population
- Patients on direct oral anticoagulant (DOAC) undergoing pacemaker or ICD implantation632 (80.1%) pacemaker
- Participants
- 789 patients
- Outcome
- Clinically relevant haematoma
- Follow-up
- Within 30 days after implantation
Methodological detailsmulticentre, consecutive patients
- Multicentre
- Consecutive patients
Main finding
As reported in the abstract
Clinically relevant haematoma within 30 days · 30 days after implantation
Clinically relevant haematoma (patients)
26
Clinically relevant haematoma (%)
3.3%
Observational data: associations, not effects.
Further findings
DOAC management
- DOAC interrupted before procedure (h, median, IQR)
- 52 (IQR 37-62)
- DOAC resumed after procedure (h, median, IQR)
- 31 (IQR 21-47)
- Total anticoagulation interruption (h, median, IQR)
- 72 (IQR 48-96)
- ≥12 h DOAC interruption before procedure
- 96%
- ≥12 h DOAC interruption after procedure
- 78%
- Pre-procedural heparin bridging
- 8.2%
- Post-procedural heparin bridging
- 3.9%
Safety
- Thromboembolic events (patients)
- 5
- Thromboembolic events (%)
- 0.6%
Original publication
Impact of peri-procedural management of direct oral anticoagulants on pocket haematoma after cardiac electronic device implantation: the StimAOD multicentre prospective study. Europace. Published 18 March 2023. doi:10.
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