Abstract 20633: Use of Novel Compression Device Reduces the Incidence of Pocket Hematoma in Anticoagulated Patients Receiving Implantable Electronic Cardiac Devices: A Pilot Study
Background: Pocket hematoma is a recognized complication after placement of cardiac implantable electronic devices (CIEDs) ranges from 2-5 %. It is associated with local discomfort, an increased risk of infection, and may require surgical evacuation. The risk of pocket hematoma further increases in the presence of therapeutic anticoagulation (AC) or concomitant use of antiplatelet therapy. Temporary discontinuation of AC may pose a significant risk for thromboembolic events and may not be possible in high-risk patients. We assessed the use of a novel vest to decrease the incidence of pocket hematoma in patients undergoing CIED implantation with uninterrupted AC.
Methods: In this observational study of uninterrupted therapeutic warfarin a novel Compress Vest was used by 20 consecutive patients (Vest group) who were compared to 20 age, gender, procedure matched patients (control group) who received standard care. Anticoagulation (100%) and antiplatelet therapy was continued in all patients in the perioperative period. The pocket was assessed at post procedure day 0, 2 and 7 for the presence of hematoma.
Results: There was no significant difference in the baseline characteristics. The incidence of pocket hematoma (PH) was significantly lower in the vest than the control group (0% vs 35%, p<0.01) at the end of 7 days. Control group had 3 small hematomas on day 2 and 7; 2 moderate hematomas and 2 large hematomas on day 7 with one patient required evacuation and blood transfusion. Vest group had 3 small hematomas on day 2 that resolved with compression by day 7. Mean INR levels ranged between 2.5 and 3.0 at all times periprocedurally.
Conclusions: The risk of pocket hematoma is significantly reduced with the use of novel compression vest. The use of Compress Vest may obviate the need for discontinuation of AC in patients undergoing CIED implantation.
Author Disclosures: D. Lakkireddy: None. K. Bartus: None. V. Nagarajan: None. R. Afzal: None. D. Atkins: None. V. Gunasekaran: None. S. Mahapatra: None. V. Swarup: None.
- © 2016 by American Heart Association, Inc.