Key result
PM placement and anticoagulation linked to decreased clotting factor activity at 7 days.
Why the study?
It remains unclear how permanent pacemaker implantation affects hemostasis parameters and how those parameters relate to postoperative sequelae.
Does permanent pacemaker placement affect blood coagulation factor activity in the perioperative period?
Observational
No
Does permanent pacemaker placement affect blood coagulation factor activity in the perioperative period?
Permanent pacemaker placement is associated with transient decreases in multiple coagulation factors, except FVII, which may indicate endothelial injury.
Hypothesis-generating for endothelial injury after pacemaker implantation; should not yet change perioperative anticoagulation practice.
BACKGROUND: Bradyarrhythmias are typically treated with permanent pacemakers (PM). The elimination of bradyarrhythmia by PM implantation improves the patient's quality of life and prognosis, but it can also result in a number of sequalae. It is still unclear how PM implantation affects the hemostasis system's parameters and how such parameters relate to different consequences after PM placement. AIM: To assess the blood coagulation factor activity in PM patients throughout the perioperative period. METHODS: Patients treated in the Department of Surgical Therapy of Cardiac Arrhythmias and Pacing at the Ryazan State "Regional Clinical Cardiology Dispensary" from April 2020 to December 2021 were included in the study. Before surgery, 7 and 30 d after PM placement, peripheral venous blood samples were withdrawn to measure the level of blood coagulation factor I (FI) and the activity of blood coagulation factors II (FII), V (FV), VII (FVII), VIII (FVIII), IX (FIX), X (FX), XI (FXI), XII (FXII). We used an automatic coagulometer Sysmex CA 660 (Sysmex Europe, Germany) and reagents from Siemens (Siemens Healthcare Diagnostics Products GmbH, Germany). RESULTS: = 0.01] 7 d after surgery, returning to baseline values at 30 d postoperatively. CONCLUSION: PM placement and anticoagulant therapy were associated with decreased activity of clotting factors FV, FVIII, FIX, FX, FXI, FXII in the postoperative period. FVII activity did not decrease within 30 d after PM placement, which may indicate endothelial injury caused by lead placement.
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Kalinin et al. (2023) conducted an observational in Bradyarrhythmias. Permanent pacemaker placement and anticoagulant therapy vs. Baseline (pre-surgery) was evaluated on Blood coagulation factor activity (p=0.01). Permanent pacemaker placement and anticoagulant therapy were associated with decreased activity of clotting factors FV, FVIII, FIX, FX, FXI, and FXII at 7 days postoperatively (P=0.01).
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