Key result
Prior antithrombotic therapy linked to ~78% more major complications after pacemaker implantation.
Why the study?
Complications that patients undergoing permanent pacemaker implantation may present remain unknown, and the impact of prior antithrombotic therapy on complication rates needed evaluation.
Do complication rates differ between patients with or without previous antithrombotic therapy undergoing permanent pacemaker implantation?
Cohort (n=310)
No
Do complication rates differ between patients with or without previous antithrombotic therapy undergoing permanent pacemaker implantation?
Absolute Event Rate: 25.1% vs 14.08%
Permanent pacemaker implantation is associated with notable complication rates, including lead dislodgement and hematomas, the latter being more frequent in patients on prior antithrombotic therapy.
Antithrombotic therapy before PPM may heighten major complication risk; leaves open optimal periprocedural strategies pending prospective trials.
Although pacemaker implantation is considered to be low risk, it is not exempt from complications and technical failures during the procedure, both in the short and long term, and the complications that such patients may present remain unknown. The aim has been to analyze the complication rates associated with permanent pacing and to identify if these differ between patients with or without previous antithrombotic therapy. We used a prospective, single center, observational study of 310 adult patients with indications of permanent pacing. They were hospitalized from 1 January to 31 December 2014 and followed up for 6 months after the pacemaker implant. The participants were distributed into two groups according to the antithrombotic therapy prior to the implant. The most frequent major complications were pneumothorax (3.87%) and lead dislodgement (8.39%), while superficial phlebitis (12.90%) and uncomplicated hematomas (22.58%) were presented as the most recurrent minor complications. Hematomas were the most frequent minor complication in the antithrombotic therapy cohort, and shoulder pain was reported as the most recurrent minor complication in the non-exposed group. Finding out about complications in pacemaker implants enables a complete view of the process, and hence the prioritization of actions aimed at improving safety and reducing associated risks.
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Carrión-Camacho et al. (2019) conducted a cohort in Indications for permanent pacing (n=310). Antithrombotic therapy vs. No antithrombotic therapy was evaluated on Major complications. Patients receiving antithrombotic therapy prior to permanent pacemaker implantation experienced a higher rate of major complications (25.10%) compared to those without antithrombotic therapy (14.08%) over a 6-month follow-up.
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