Pocket haematoma and non-pocket bleeding are frequent and potentially dangerous complications of an implantation of a pacemaker, implantable cardioverter-defibrillator (ICD) or cardiac resynchronisation therapy device (CRT).
1-3 Moreover, a large number of patients receive either antiplatelet or anticoagulation therapy for the treatment of coexisting morbidities. According to the contemporary guidelines, the majority of patients with acute coronary syndromes (ACS) and after percutaneous coronary interventions (PCI) require treatment with a combination of two antiplatelet drugs (dual antiplatelet therapy, DAT). In addition, a temporary or permanent withdrawal of DAT is discouraged due to the risk of stent thrombosis.
4-8 On the other hand, increased postoperative bleeding and morbidity after coronary artery bypass surgery (CABG) or noncardiac surgical procedures in patients receiving DAT have been reported.
9-11 Nowadays, the number of patients undergoing a pacemaker, ICD or CRT implantation and receiving two antiplatelet drugs in the perioperative period has not been assessed. Moreover, the risk of bleeding complications in this group of patients has not been sufficiently elucidated. …
