Preparation for pacemaker or implantable cardiac defibrillator implants in patients with high risk of thrombo-embolic events: oral anticoagulation or bridging with intravenous heparin? A prospective randomized trial
Why the study?
Does maintenance of oral anticoagulation reduce hospital stay without increasing complications compared to bridging with intravenous heparin in patients with high risk of thrombo-embolic events undergoing pacemaker or ICD implantation?
Population
101 consecutive patients with high risk for embolic events and indication for implant/replacement of a…
Comparison
Maintenance of oral anticoagulation to reach an… vs Bridging from oral anticoagulation to…
Design
RCT, randomized to two anticoagulant strategies
Follow-up
45 days
Authors
Discussion
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Member takes
Implication
Supports uninterrupted OAC during device implantation in high-risk patients; confirms equivalent safety with shorter hospitalization versus heparin bridging.
Structured PICO
Does maintenance of oral anticoagulation reduce hospital stay without increasing complications compared to bridging with intravenous heparin in patients with high risk of thrombo-embolic events undergoing pacemaker or ICD implantation?
P
Population
101 consecutive patients with high risk for embolic events and indication for implant/replacement of a pacemaker/ICD
I
Intervention
Maintenance of oral anticoagulation (OAC) to reach an INR = 2 +/- 0.3 at the day of the procedure
C
Comparator
Bridging from oral anticoagulation to intravenous heparin infusion
O
Outcome
Haemorrhagic and thrombo-embolic complications evaluated at discharge, 15 and 45 days after the proceduresafety
Maintaining oral anticoagulation during pacemaker or ICD implantation is as safe as bridging with intravenous heparin and significantly reduces hospital stay.
Cite This Study
Tolosana et al. (2009) studied this question.