Effect of different antiplatelet or anticoagulation therapy on postoperative pocket hematoma after electrophysiological devices placement

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Objective To investigate the effect of different antiplatelet or anticoagulation therapy on postoperative pocket hematoma after electrophysiological devices placements (EPD). Methods The selected patients were taking anti-platelet or anticoagulation therapy and needed implanted permanent pacemaker, cardiac resynchronization therapy and implantable cardioversion defibrillator in our Beijing Anzhen hospital from January 2010 to January 2013. According to the type of therapy, patients were divided into 4 groups: dual anti-platelet therapy (DAP, aspirin and clopidogrel) group, low-molecular-weight heparin (LMWH, enoxaparin) bridging group, aspirin alone (ASA) group and warfarin group. The incidences of pocket hematoma after electrophysiological devices placements were observed in groups. Results A total of 324 patients were enrolled in the study. The incidence of pocket hematoma was higher in LMWH bridging group than in the other 3 groups 〔18.25% (15/81) vs. 4.93% (4/81), 3.70% (3/81), 2.47% (2/81), all P 0.05). The multiple logistic regression analysis revealed that LMWH bridging therapy was an independent risk factor for the development of pocket hematoma: patients with LMWH bridging therapy were 7 fold more likely to develop pocket hematomas than the individuals with other treatment (OR=7.124, 95% CI: 1.861-27.271). Conclusions LMWH bridging therapy increases the risk of development of pocket hematomas after electrophysiological devices placement. Key words: Aspirin; Warfarin; Heparin; Heart-assist devices; Hematoma