title: Arguments to Apply Epinephrine for Pocket Hematoma Reduction. The MAITRE Study.
abstract: Pocket hematoma (PH) is a common complication of implantations of cardiac electrophysiological devices with occurring at a particularly high rate in patients on oral anticoagulation or antiplatelet treatment. Different pharmacological agents with hemostatic effect are used to avoid PH. We supposed that the vasoconstrictor effects of epinephrine may reduce bleeding extent and be effective in prevention of PH. Maitre is the first clinical trial conducted with an aim to show the safety and efficacy of epinephrine in PH prophylaxis. We randomized 133 patients to receive either epinephrine or saline solution, which were added to a local anesthetic administered during pacemaker implantation. In cases of diffuse bleeding a method of pocket drainage was effectively used. Results showed that risk of PH was significantly higher in the group receiving epinephrine. We conclude that a local epinephrine effect may lead to a false impression of adequate hemostasis and force a surgeon to refuse from drainage insertion.
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Nikolay
authors.initials: N
authors.lastname: Ilov
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Nikolay
authors.initials: N
authors.lastname: Ilov
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Anatoly
authors.initials: A
authors.lastname: Nechepurenko
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Albert
authors.initials: A
authors.lastname: Abdulkadyrov
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Damir
authors.initials: D
authors.lastname: Paskeev
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Damrina
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Kulikova
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Terent'eva
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Dinara
authors.initials: D
authors.lastname: Stompel
authors.affiliation: Federal Center for Cardiovascular Surgery, Astrakhan, Russia. Presented in Venice Arrhythmias 2015, Venice, Italy.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Tarasov
keywords: Dual Antiplatelet; Electrophysiological; Epinephrine; Pocket Hematoma