Is antiarrhythmia device implantation safe under dual antiplatelet therapy?
BACKGROUND
Device implantations in patients on dual antiplatelet-therapy (DA-therapy) continue to rise. The aim of our study was to compile and analyze data on complications of antiarrhythmia device implantation under DA-therapy.


METHODS
We prospectively collected data on all device implantations in our department from January 2008 until February 2009. The control group was comprised of patients on acetylsalicylic acid alone or no antiplatelet medication at all (318 subjects). The DA-therapy group consisted of 109 patients of whom 71 were analyzed retrospectively (implantations from 2002 to 2007).


RESULTS
Procedure times were significantly longer in DA-therapy patients receiving a pacemaker for the first time. In contrast, procedure times did not differ significantly between the two study groups for implantable cardioverter defibrillator (ICD) implantations and for pacemaker replacements. Fluid losses via drainage systems and drainage times were significantly increased in the DA-therapy group as compared with the control group after pacemaker but not after ICD implantations. Importantly, there were no significant differences in complication rates, particularly the hematoma rate, between the DA-therapy and the control group.


CONCLUSIONS
When drainage systems are used, antiarrhythmia device implantation is safe and can be performed without significantly increased risk of clinically relevant hematoma in patients on continued DA-therapy. (PACE 2010; 394-399).
Dreger
Henryk
H
From the Medizinische Klinik für Kardiologie und Angiologie, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany. henryk.dreger@charite.de
Grohmann
Andrea
A
Bondke
Hansjürgen
H
Gast
Boris
B
Baumann
Gert
G
Melzer
Christoph
C
D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable; D005260:Female; D006406:Hematoma / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000139:chemically induced; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012189:Retrospective Studies
D010975:Platelet Aggregation Inhibitors