[Oral anticoagulation doesn't increase hemorrhagic risk in patients undergoing a cardiac pacemaker or defibrillator implantation].
OBJECTIVE
This study was designed to assess the hypothesis that the implantation or the replacement of a cardiac stimulator or defibrillator in patients receiving oral anticoagulants with an INR≥2 doesn't increase the hemorrhagic risk in comparison with patients for whom the treatment has been interrupted temporarily (INR<2) or with patients not receiving anticoagulants (control group).


RESULTS
We performed a retrospective chart review of bleeding complications in all patients undergoing pacemaker or ICD implantation or replacement between January 2007 and may 2009. In this cohort, 43 patients (10%) were implanted with an INR≥2 while 36 patients (8%) were implanted with an INR<2 and 352 patients (82%) didn't receive anticoagulants. No complication (0/36) has been observed in patients having an INR<2, while 3/43 (7%) complications have been observed in patients with an INR≥2 and 13/352 (3.7%) in patients in the control group (p=0.3093). Duration of the hospital stay was similar in the three groups: 6.2 days in patients with an INR<2, 6.8 days in the group with an INR≥2 and 6.2days in the control group (p=0.686).


CONCLUSIONS
Pacemaker and ICD implantation or replacement without withdrawing of oral anticoagulants and an INR≥2 was not associated with an increase of the hemorrhagic risk.
Amara
W
W
Unité de rythmologie, GHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France. walamara@yahoo.fr
Ben Youssef
I
I
Bonny
A
A
Faron
M
M
Monsel
F
F
Sergent
J
J
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D017147:Defibrillators, Implantable; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D019106:Postoperative Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology*; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D012307:Risk Factors
D000925:Anticoagulants