Management of Perioperative Anticoagulation for Device Implantation.

Merrill H Stewart, Daniel P Morin

Journal: Cardiac electrophysiology clinics 2019;10(1):99-109

PMID: 29428146

Full Text on Elsevier Science View on PubMed

Abstract

Periprocedural management of anticoagulation for cardiac device implantation has evolved over the past 20 years. The traditional paradigm of vitamin K antagonist interruption with heparin bridging has now been shown to be less safe than continuation of vitamin K antagonists at therapeutic levels. Dual antiplatelet therapy during device implantation poses substantial risk but is often necessary. The safest dosing strategy for newer direct oral anticoagulants is still not clear.

Address: John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, LA 70121, USA.; John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, LA 70121, USA. Electronic address: [email protected].

DOI: 10.1016/j.ccep.2017.11.008

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MeSH Terms: Anticoagulants, Defibrillators, Implantable, Heparin, Humans, Pacemaker, Artificial, Perioperative Care, Prosthesis Implantation, Thromboembolism, Warfarin