{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T15:33:00Z","timestamp":1781451180352,"version":"3.54.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,3,18]],"date-time":"2023-03-18T00:00:00Z","timestamp":1679097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Bristol-Myers Squibb\u2013Pfizer Alliance","award":["NCT03879473"],"award-info":[{"award-number":["NCT03879473"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The study aims to investigate the impact of direct oral anticoagulant (DOAC) management on the incidence of pocket haematoma in patients undergoing pacemaker or implantable cardioverter\u2013defibrillator implantation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>All consecutive patients receiving DOAC and undergoing cardiac electronic device implantation were included in a large multicentre prospective observational study (NCT 03879473). The primary endpoint was clinically relevant haematoma within 30 days after implantation. Overall, 789 patients were enrolled [median age 80 (IQR 72\u201385) years old, 36.4% women, median CHA2DS2-VASc score 4 (IQR 0\u20138)], of which 632 (80.1%) received a pacemaker implantation. Antiplatelet therapy was combined with DOAC in 146 patients (18.5%). Direct oral anticoagulants (DOACs) were interrupted 52 (IQR 37\u201362) h before the procedure and resumed 31 (IQR 21\u201347) h later. Ninety-six percent of the patients had at least 12\u2005h DOAC interruption before the procedure, and 78% had at least 12\u2005h DOAC interruption after the procedure. Overall, anticoagulation was interrupted for 72 (IQR 48\u201396) h. Pre- or post-procedural heparin bridging was used in 8.2% and 3.9%, respectively. Timing of DOAC interruption of resumption was not associated with clinically relevant haematoma. Clinically relevant haematoma occurred in 26 patients (3.3%), and thromboembolic events occurred in 5 patients (0.6%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this large real-life registry where most patients had DOAC interruption, clinically relevant haematoma was rare. Despite DOAC interruption and high CHA2DS2-VASc score, thromboembolic events occurred seldomly, highlighting that bleeding exceeds thromboembolic risk in this peri-procedural period. Future research is needed to identify risk factors for clinically relevant haematoma and meaningfully guide clinicians in optimizing DOAC management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euad057","type":"journal-article","created":{"date-parts":[[2023,3,18]],"date-time":"2023-03-18T07:06:36Z","timestamp":1679123196000},"source":"Crossref","is-referenced-by-count":8,"title":["Impact of peri-procedural management of direct oral anticoagulants on pocket haematoma after cardiac electronic device implantation: the StimAOD multicentre prospective study"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6148-3523","authenticated-orcid":false,"given":"Anne-C\u00e9line","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Cardiology, AP HP, European Hospital Georges Pompidou , 20 rue Leblanc, 75015 Paris , France"},{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM, Innovative Therapies in Haemostasis , 4 Rue de l'Observatoire 75006 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1527-0332","authenticated-orcid":false,"given":"Orianne","family":"Weizman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AP HP, European Hospital Georges Pompidou , 20 rue Leblanc, 75015 Paris , France"},{"name":"Paris Cardiovascular Research Center (PARCC), INSERM Unit 970 , 56 rue Leblanc, 75015 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1080-7425","authenticated-orcid":false,"given":"Jean-Marc","family":"Sellal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nancy University Hospital , Rue du Morvan, 54500 Vand\u0153uvre-l\u00e8s-Nancy , France"},{"name":"IADI, INSERM U1254, Universit\u00e9 de Lorraine , Rue du Morvan, 54500 Vand\u0153uvre-l\u00e8s-Nancy , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5971-1235","authenticated-orcid":false,"given":"Vincent","family":"Algalarrondo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rhythm Disorders Unit, Bichat Hospital, AP-HP , 46 Rue Henri Huchard, 75018 Paris , France"},{"name":"Paris Cit\u00e9 University , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8347-2550","authenticated-orcid":false,"given":"Walid","family":"Amara","sequence":"additional","affiliation":[{"name":"Department of Cardiology, GHI Le Raincy Montfermeil , 10 Rue du G\u00e9n\u00e9ral Leclerc, 93370 Montfermeil , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1703-8075","authenticated-orcid":false,"given":"Abdeslam","family":"Bouzeman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Parly 2 Private Hospital , 21 Rue Moxouris, 78150 Le Chesnay-Rocquencourt , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Gandjbakhch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Piti\u00e9-Salp\u00eatri\u00e8re University Hospital, Institute of Cardiology , 47-83 Bd de l'H\u00f4pital, 75013 Paris , France"},{"name":"Sorbonne Universit\u00e9s, UPMC Univ Paris 06, INSERM , 1166 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8462-2218","authenticated-orcid":false,"given":"Nicolas","family":"Lellouche","sequence":"additional","affiliation":[{"name":"Department of Cardiology, H\u00f4pital Henri MONDOR, AP-HP , 1 Rue Gustave Eiffel, 94000 Cr\u00e9teil , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5616-5408","authenticated-orcid":false,"given":"Jules","family":"Louembe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, H\u00f4pital d\u2019Instruction des Arm\u00e9es Percy , 2 Rue Lieutenant Raoul Batany, 92140 Clamart , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4823-1556","authenticated-orcid":false,"given":"Aymeric","family":"Menet","sequence":"additional","affiliation":[{"name":"Laboratoire ETHICS, Groupement des H\u00f4pitaux de l'Institut Catholique de Lille, Service de Cardiologie USIC, Universit\u00e9 Catholique de Lille , Rue du Grand But, 59400 Lille , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6167-4947","authenticated-orcid":false,"given":"Pierre","family":"Roumegou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Poitiers , 2 Rue de la Mil\u00e9trie, 86000 Poitiers , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Treguer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinique Saint Joseph , 51 Rue de la Foucaudi\u00e8re, 49800 Tr\u00e9laz\u00e9 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4289-6883","authenticated-orcid":false,"given":"Anne","family":"Godier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM, Innovative Therapies in Haemostasis , 4 Rue de l'Observatoire 75006 Paris , France"},{"name":"Department of Anaesthesiology and Critical Care, APHP, H\u00f4pital Europ\u00e9en Georges Pompidou , 20 rue Leblanc, 75015 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-7042","authenticated-orcid":false,"given":"Serge","family":"Boveda","sequence":"additional","affiliation":[{"name":"Paris Cardiovascular Research Center (PARCC), INSERM Unit 970 , 56 rue Leblanc, 75015 Paris , France"},{"name":"Cardiology\u2014Heart Rhythm Management Department, Clinique Pasteur , 45 Avenue de Lombez, 31076 Toulouse , France"},{"name":"Universiteit Ziekenhuis, Vrije Universiteit Brussel (VUB) , Laarbeeklaan 101, 1090 Jette Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9350-2437","authenticated-orcid":false,"given":"Rodrigue","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Poitiers , 2 Rue de la Mil\u00e9trie, 86000 Poitiers , France"},{"name":"CIC1402, University Hospital of Poitiers , 86021 Poitiers , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7227-3428","authenticated-orcid":false,"given":"Eloi","family":"Marijon","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AP HP, European Hospital Georges Pompidou , 20 rue Leblanc, 75015 Paris , France"},{"name":"Paris Cardiovascular Research Center (PARCC), INSERM Unit 970 , 56 rue Leblanc, 75015 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,18]]},"reference":[{"key":"2023053008244673800_euad057-B1","doi-asserted-by":"crossref","first-page":"2062","DOI":"10.1161\/CIRCULATIONAHA.113.006027","article-title":"Management of anticoagulation around pacemaker and defibrillator surgery","volume":"129","author":"Birnie","year":"2014","journal-title":"Circulation"},{"key":"2023053008244673800_euad057-B2","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1161\/CIRCEP.111.969105","article-title":"Meta-analysis of bleeding complications associated with cardiac rhythm device implantation","volume":"5","author":"Bernard","year":"2012","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2023053008244673800_euad057-B3","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1016\/j.jacc.2016.01.009","article-title":"Clinically significant pocket hematoma increases long-term risk of device infection: BRUISE CONTROL INFECTION study","volume":"67","author":"Essebag","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2023053008244673800_euad057-B4","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1093\/europace\/euv053","article-title":"Risk factors for cardiac implantable electronic device infection: a systematic review and meta-analysis","volume":"17","author":"Polyzos","year":"2015","journal-title":"Europace"},{"key":"2023053008244673800_euad057-B5","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1093\/europace\/euv075","article-title":"Impact of haematoma after pacemaker and CRT device implantation on hospitalization costs, length of stay, and mortality: a population-based study","volume":"17","author":"Sridhar","year":"2015","journal-title":"Europace"},{"key":"2023053008244673800_euad057-B6","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1093\/europace\/euv190","article-title":"Antithrombotic management in patients undergoing electrophysiological procedures: a European Heart Rhythm Association (EHRA) position document endorsed by the ESC Working Group Thrombosis, Heart Rhythm Society (HRS), and Asia Pacific Heart Rhythm Society (APHRS)","volume":"17","author":"Sticherling","year":"2015","journal-title":"Europace"},{"key":"2023053008244673800_euad057-B7","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1093\/eurheartj\/ehy136","article-title":"The 2018 European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation","volume":"39","author":"Steffel","year":"2018","journal-title":"Eur Heart J"},{"key":"2023053008244673800_euad057-B8","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1093\/europace\/euab065","article-title":"2021 European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation","volume":"23","author":"Steffel","year":"2021","journal-title":"Europace"},{"key":"2023053008244673800_euad057-B9","doi-asserted-by":"crossref","first-page":"e604","DOI":"10.1161\/CIR.0000000000000477","article-title":"Management of patients on non-vitamin K antagonist oral anticoagulants in the acute care and periprocedural setting: a scientific statement from the American Heart Association","volume":"135","author":"Raval","year":"2017","journal-title":"Circulation"},{"key":"2023053008244673800_euad057-B10","doi-asserted-by":"crossref","first-page":"3973","DOI":"10.1093\/eurheartj\/ehy413","article-title":"Continued vs. interrupted direct oral anticoagulants at the time of device surgery, in patients with moderate to high risk of arterial thrombo-embolic events (BRUISE CONTROL-2)","volume":"39","author":"Birnie","year":"2018","journal-title":"Eur Heart J"},{"key":"2023053008244673800_euad057-B11","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1093\/europace\/euaa367","article-title":"EHRA Expert consensus statement and practical guide on optimal implantation technique for conventional pacemakers and implantable cardioverter-defibrillators: endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS)","volume":"23","author":"Burri","year":"2021","journal-title":"Europace"},{"key":"2023053008244673800_euad057-B12","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","article-title":"2021 ESC guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"42","author":"Glikson","year":"2021","journal-title":"Eur Heart J"},{"key":"2023053008244673800_euad057-B13","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"335","author":"von Elm","year":"2007","journal-title":"BMJ"},{"key":"2023053008244673800_euad057-B14","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1093\/europace\/eut423","article-title":"Treatment with novel oral anticoagulants in a real-world cohort of patients undergoing cardiac rhythm device implantations","volume":"16","author":"Kosiuk","year":"2014","journal-title":"Europace"},{"key":"2023053008244673800_euad057-B15","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1093\/europace\/euw127","article-title":"Perioperative management of antithrombotic treatment during implantation or revision of cardiac implantable electronic devices: the European Snapshot Survey on Procedural Routines for Electronic Device Implantation (ESS-PREDI)","volume":"18","author":"Deharo","year":"2016","journal-title":"Europace"},{"key":"2023053008244673800_euad057-B16","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1111\/pace.14091","article-title":"Continued versus interrupted direct oral anticoagulation for cardiac electronic device implantation: a systematic review","volume":"43","author":"Mendoza","year":"2020","journal-title":"Pacing Clin Electrophysiol"},{"key":"2023053008244673800_euad057-B17","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1056\/NEJMoa1302946","article-title":"Pacemaker or defibrillator surgery without interruption of anticoagulation","volume":"368","author":"Birnie","year":"2013","journal-title":"N Engl J Med"},{"key":"2023053008244673800_euad057-B18","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.amjcard.2016.12.012","article-title":"Frequency of \u2018pocket\u2019 hematoma in patients receiving vitamin K antagonist and antiplatelet therapy at the time of pacemaker or cardioverter defibrillator implantation (from the POCKET study)","volume":"119","author":"Malag\u00f9","year":"2017","journal-title":"Am J Cardiol"},{"key":"2023053008244673800_euad057-B19","doi-asserted-by":"crossref","first-page":"3826","DOI":"10.1093\/eurheartj\/ehac270","article-title":"2022 ESC guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery","volume":"43","author":"Halvorsen","year":"2022","journal-title":"Eur Heart J"},{"key":"2023053008244673800_euad057-B20","doi-asserted-by":"crossref","first-page":"e007545","DOI":"10.1161\/CIRCEP.119.007545","article-title":"Effect of direct oral anticoagulants, warfarin, and antiplatelet agents on risk of device pocket hematoma: combined analysis of BRUISE CONTROL 1 and 2","volume":"12","author":"Essebag","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2023053008244673800_euad057-B21","doi-asserted-by":"crossref","first-page":"2376","DOI":"10.1016\/j.jacc.2009.12.056","article-title":"Dual antiplatelet therapy and heparin \u2018bridging\u2019 significantly increase the risk of bleeding complications after pacemaker or implantable cardioverter-defibrillator device implantation","volume":"55","author":"Tompkins","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2023053008244673800_euad057-B22","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1161\/CIRCULATIONAHA.110.976076","article-title":"Complication rates associated with pacemaker or implantable cardioverter-defibrillator generator replacements and upgrade procedures: results from the REPLACE registry","volume":"122","author":"Poole","year":"2010","journal-title":"Circulation"},{"key":"2023053008244673800_euad057-B23","first-page":"e008372","article-title":"Device-pocket hematoma after cardiac implantable electronic devices","volume":"13","author":"Notaristefano","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2023053008244673800_euad057-B24","first-page":"1002","article-title":"Wound haematoma following defibrillator implantation: incidence and predictors in the Shockless Implant Evaluation (SIMPLE) trial","volume":"19","author":"Masiero","year":"2017","journal-title":"Europace"}],"container-title":["Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/25\/5\/euad057\/50484948\/euad057.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/25\/5\/euad057\/50484948\/euad057.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T08:25:15Z","timestamp":1685435115000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/doi\/10.1093\/europace\/euad057\/7080277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,18]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5,19]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euad057","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,5]]},"published":{"date-parts":[[2023,3,18]]},"article-number":"euad057"}}