Oral anticoagulants in cardiac electronic devices implantation – case and recent publications review
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1st Department of Cardiology, Medical University of Warsaw, Poland
Sri Jayadeva Institute of Cardiology, Bangalore, Indie
Jakub Szwed   

1st Department of Cardiology, Medical University of Warsaw, Poland
Publication date: 2019-02-26
Heart Beat 2018;3:114–116
Every year, numerous cardiac electronic devices implantations are performed in patients on oral anticoagulant therapy. This procedure has medium risk of bleeding, therefore the guidelines suggest discontinuation of VKA (vitamin K antagonists) with heparin introduction and interrupted of NOAC therapy without heparin bridging before the implantation. In addition to the guidelines, we had trials results, which showed greater benefits from continuing VKA therapy during CIED implantation without including heparin. This option of therapy reduces the risk of hemorrhagic complications in patients after CIED implantation. The first large publication appeared this year and considers peri-implantation continuation of NOAC therapy. Riccardii et al. have shown that there is no significant difference between interrupted and uninterrupted NOAC therapy before the procedure. This study includes information of the possibilities of using oral anticoagulants in the CIED implantation procedure and a case report of a patient who was treated according to the guidelines.