{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T18:27:46Z","timestamp":1773080866068,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small studies have described the safety of uninterrupted direct oral anticoagulant (DOAC) use in atrial fibrillation (AF) patients undergoing elective, cardiac implantable electronic device (CIED) placement. Real\u2010world practice patterns and associated outcomes remain poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Describe DOAC usage trends following uncomplicated, outpatient CIED placement in AF patients and evaluate clinical outcomes based on DOAC status at discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using data from the National Cardiovascular Data Registry, AF patients with CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc\u00a0\u2265\u00a02 undergoing uncomplicated, outpatient CIED placement from April 2016 to December 2019 were stratified by DOAC prescription at discharge. Short and longer\u2010term temporal trends and post\u2010discharge outcomes were assessed using Centers for Medicare and Medicaid (CMS) claims.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 59,169 AF patients with elevated thromboembolic eligible for DOAC therapy who underwent elective, new CIED implant or generator replacement, 32,025 (54.1%) were discharged on a DOAC. Annual rates of DOAC use at discharge increased from 47.0% in 2016 to 62.5% in 2019 (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001). Overall, patients discharged on DOAC had higher adjusted rates of pocket hematoma (0.51%\u00a0vs. 0.33%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0007) and lower rates of stroke (2.9%\u00a0vs. 3.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.05) at 30\u2010days but no significant differences in device infection or need for revision at 30\u2010days or 1\u2010year. Those undergoing new CIED implant had higher rates of pocket hematoma at 30\u2010days (0.53%\u00a0vs. 0.36%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.02) and need for device revision at 1\u2010year (1.6%\u00a0vs. 1.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In AF patients undergoing CIED implantation, about half were discharged on DOACs, with increasing rates of DOAC resumption immediately following post\u2010CIED implantation over the study period. Those discharged on DOACs had modestly higher rates of pocket hematoma or need for device revision but similar risk of device infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70016","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T17:33:36Z","timestamp":1753983216000},"page":"859-869","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of Direct Oral Anticoagulants Following Cardiac Implantable Electronic Device Placement"],"prefix":"10.1111","volume":"48","author":[{"given":"Carmel","family":"Ashur","sequence":"first","affiliation":[{"name":"Division of Cardiology University of Colorado School of Medicine Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Qin","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation Yale\u2010New Haven Hospital  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl E.","family":"Minges","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation Yale\u2010New Haven Hospital  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James V.","family":"Freeman","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation Yale\u2010New Haven Hospital  New Haven Connecticut USA"},{"name":"Division of Cardiology Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana M.","family":"Al\u2010Khatib","sequence":"additional","affiliation":[{"name":"Division of Cardiology Duke University Medical Center  Durham North Carolina USA"},{"name":"Duke Clinical Research Institute Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven M.","family":"Bradley","sequence":"additional","affiliation":[{"name":"Division of Cardiology Allina Health Minneapolis Heart Institute  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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