In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Bleeding complications after implantation of active cardiovascular implantable devices in an era of triple therapy and novel antithrombotic drugs.

Session The bad and the ugly of device therapy

Speaker Hendrik Bonnemeier

Event : ESC Congress 2013

  • Topic : arrhythmias and device therapy
  • Sub-topic : Antibradycardia Pacing
  • Session type : Moderated Posters

Authors : L Heimbaecher (Kiel,DE), G Senel (Kiel,DE), S Sandrock (Kiel,DE), T Demming (Kiel,DE), H Bonnemeier (Kiel,DE)

Authors:
L. Heimbaecher1 , G. Senel1 , S. Sandrock1 , T. Demming1 , H. Bonnemeier1 , 1Innere Medizin III, Universitätsklinikum Schleswig-Hostein, Campus Kiel - Kiel - Germany ,

Citation:
European Heart Journal ( 2013 ) 34 ( Abstract Supplement ), 660

Introduction: Bleeding complications (eg. pocket hematoma) are still common complications after implantation of active cardiovascular implantable devices (CIEDs). We investigated the influence of the type of CIED, the implantation strategy, and the underlying antiplatelet- and anticoagulation-therapy on bleeding complication.

Methods: Between 2006 and 2012, a total of 3,082 CIEDs (Pacemakers: n=1,689; ICD/CRT/CCM: n= 1393) were implanted at our institution. There was no perioperative anticoagulation in 17.7%, ASA or thienopyridine monotherapy in 33.5%, anticoagulation with phenprocoumon, heparins or novel oral anticoagulants (NOAKs) monotherapy in 16.3%, and a dual- or triple-combination of different antithrombotic drugs in 32.5% of the patients. HAS-BLED-score was >3 in 17.5% of the patients. Bleeding complications were defined as pocket hematoma, pericardial effusion, hematothorax, drop of hemoglobin >2mg/dl, and transfusion of >2 erythrocyte concentrates.

Results: No patient died due to bleeding complications. The overall incidence of bleeding complications was 7,2%. Reoperation for pocket hematoma or hematothorax was required in 1.26%. Patients with HAS-BLED-Score >3, patients on dual- or triple combination of antithrombotic drugs, patients on low molecular weight heparins (LMWHs), and patients on dabigatran, ticagrelor or prasugrel exhibited a higher incidence for bleeding complications.

Conclusions: Even in an era of novel antithrombotic drugs and dual-/triple-anticoagulation, the rate of bleeding complications is comparable to published data of the last decade. The use of bridging therapy with LMWHs and especially its combination with ASA/thienopyridine treatment are highly predictive for bleeding complications during or after CIEDs-surgery.

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are