{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:25:12Z","timestamp":1763036712033},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2012,9,14]],"date-time":"2012-09-14T00:00:00Z","timestamp":1347580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:p><jats:bold>\n            <jats:italic>Background:<\/jats:italic>\n          <\/jats:bold>\n          <jats:italic>Current guidelines recommend bridging anticoagulation in patients undergoing cardiac rhythm device surgery with a \u201cmoderate to high risk\u201d of thromboembolism. Patients at \u201clow risk\u201d are advised to stop oral anticoagulation without bridging to the procedure. This study examines real world adherence to accepted guidelines and the clinical sequelae of nonadherence.<\/jats:italic><\/jats:p><jats:p><jats:bold>\n            <jats:italic>Methods:<\/jats:italic>\n          <\/jats:bold>\n          <jats:italic>We performed a review of all patients undergoing device surgery receiving chronic anticoagulation over a prespecified time period of 14 months. Patients were classified per American College of Chest Physician guidelines as \u201cmoderate\/high risk\u201d or \u201clow risk\u201d of thromboembolism. We then compared perioperative management of anticoagulation to guideline recommendations and assessed the rate of perioperative bleeding and thromboembolism.<\/jats:italic><\/jats:p><jats:p><jats:bold>\n            <jats:italic>Results:<\/jats:italic>\n          <\/jats:bold>\n          <jats:italic>One hundred and twenty\u2010nine patients were included in this study. Sixty\u2010two (48%) were classified as \u201cmoderate\/high risk\u201d and 67 (52%) \u201clow risk.\u201d In the \u201cmoderate\/high risk\u201d group 47\/62 (76%) received perioperative anticoagulation but only 25\/62 (40%) were bridged both pre\u2010 and postprocedure or maintained on uninterrupted warfarin. In the \u201clow risk\u201d group, 22\/67 (33%) received bridging therapy. Device pocket hematoma or perioperative bleeding occurred in 10\/129 (8%) with 4\/10 receiving inappropriate bridging for a calculated low risk of thromboembolism. There were no perioperative thromboembolisms.<\/jats:italic><\/jats:p><jats:p><jats:bold>\n            <jats:italic>Conclusions:<\/jats:italic>\n          <\/jats:bold>\n          <jats:italic>Our study identified significant underutilization of bridging, particularly in the postoperative period, in patients at \u201cmoderate\/high risk\u201d of thromboembolism. Conversely, bridging was overused in \u201clow risk\u201d patients and associated with bleeding complications. Physicians should be urged to follow current expert guidelines in regard to bridging anticoagulation for cardiac rhythm device surgery. (PACE 2012;35:1480\u20131486)<\/jats:italic><\/jats:p>","DOI":"10.1111\/j.1540-8159.2012.03516.x","type":"journal-article","created":{"date-parts":[[2012,9,15]],"date-time":"2012-09-15T09:59:05Z","timestamp":1347703145000},"page":"1480-1486","source":"Crossref","is-referenced-by-count":8,"title":["Anticoagulation Bridging Around Device Surgery: Compliance with Guidelines"],"prefix":"10.1111","volume":"35","author":[{"given":"MARK J.","family":"PERRIN","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"BRIAN Z.","family":"VEZI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ANDREW C.","family":"HA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ARIEH","family":"KEREN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PABLO B.","family":"NERY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DAVID H.","family":"BIRNIE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,9,14]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.22.2864"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0675"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199705223362107"},{"key":"e_1_2_6_5_2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0022-5223(19)38673-8","article-title":"A 5 1\/2 year experience with the St. Jude Medical cardiac valve prosthesis. Early and late results of 737 valve replacements in 671 patients","volume":"90","author":"Baudet EM","year":"1985","journal-title":"J Thorac Cardiovasc Surg"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.02.024"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.185700"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.08753.x"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2009.09.017"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.3.246"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2006.12.019"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl015"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00633-1"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2008.02247.x"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2008.03080.x"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.12.056"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000142859.77578.C9"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.02.049"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.678664"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.02.018"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.12.016"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0b013e32831bef53"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1540-8159.2012.03516.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1540-8159.2012.03516.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T17:05:11Z","timestamp":1698685511000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1540-8159.2012.03516.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9,14]]},"references-count":21,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["10.1111\/j.1540-8159.2012.03516.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1540-8159.2012.03516.x","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,9,14]]}}}