The effect of anticoagulant or antiplatelet drug on pocket hemorrhage after pacemaker implantation

Objective To investigate the effect of anticoagulant or antiplatelet drug on pocket hemorrhage after pacemaker implantation during perioperation. Methods To review patients′ data who received pacemaker implantation or replacement in our hospital since 2006, and analyze the patients′data who didn′t discontinue anticoagulant or antiplatelet therapy during perioperation because of high-risk factors for thromboembolic event.The protocal of anticoagulant or antiplatelet using in perioperation and postoperation complication of pocket bleeding were studied. Results Twenty-six patients were successfully implanted pacemarker, 15 patients of whom without pocket bleeding, 4 patients with 5 cm×5 cm ecchymosis in pocket area, and 7 patients with pocket hematoma. Severe bleeding happened in 5 patients who took dual antiplatelet or anticoagulant treatment. Pocket bleedings were gradually absorbed by properly management. Following-up 3.0±2.6 months, no late pocket hematoma happened. Conclusion ① Taking single-antiplatelet or using LMWH instead of dual-antiplatelet in short-term during the perioperation is relatively safe. ② Taking dual-antiplatelet or only using anticoagulant only during the perioperation has a high incidence of pocket bleeding, and using anticoagulant only usually causes severe bleeding.