Related Experiment Video

Updated: May 9, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Cardiovascular implantable electronic device implantation with uninterrupted dabigatran: comparison to uninterrupted

John M Jennings1, Robert Robichaux, H Thomas McElderry

  • 1University of Alabama at Birmingham, Birmingham, Alabama, USA.

Journal of Cardiovascular Electrophysiology
|July 30, 2013
PubMed

Insights

Continuing oral anticoagulation (OAC) with dabigatran during cardiovascular implantable electronic device (CIED) procedures is as safe as using warfarin, with similar bleeding risks. Combining OAC with antiplatelet drugs increases complication risks.

Area of Science:

  • Cardiology
  • Pharmacology
  • Medical Devices

Background:

  • Oral anticoagulation (OAC) management during cardiovascular implantable electronic device (CIED) procedures is critical.
  • Warfarin continuation is often preferred over heparin bridging, but dabigatran's safety in this context is less clear.

Purpose of the Study:

  • To compare bleeding and thromboembolic risks of uninterrupted dabigatran versus warfarin during CIED implantation, replacement, or revision.
  • To assess the safety of continuing dabigatran without interruption for CIED procedures.

Main Methods:

  • Retrospective comparison of patients undergoing CIED procedures.
  • Patients received either uninterrupted dabigatran (D), interrupted dabigatran, or uninterrupted warfarin (W).
  • Outcomes included bleeding complications (e.g., pericardial effusion, pocket hematomas) and thromboembolic events.

Main Results:

  • Bleeding complication rates were similar: 2.1% for uninterrupted dabigatran (1/48), 0% for interrupted dabigatran (0/14), and 4.6% for warfarin (9/195).
  • No significant difference in bleeding complications between uninterrupted dabigatran and warfarin (P = 0.69).
  • Fifty percent of bleeding events occurred when OAC was combined with antiplatelet medications.

Conclusions:

  • Uninterrupted dabigatran is a safe strategy for CIED procedures, comparable to warfarin in terms of bleeding risk.
  • Concomitant use of antiplatelet agents with OAC increases the risk of bleeding complications during CIED procedures.
Abstract

Keywords:
cardiovascular implantable electronic device (CIED)dabigatranimplantable cardioverter defibrillatorpacemakerwarfarin

More Related Videos

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...