Use of a pocket compression device for the prevention and treatment of pocket hematoma after pacemaker and defibrillator implantation (STOP-HEMATOMA-I)

Mohit K. Turagam, Darbhamulla V. Nagarajan, Krzysztof Bartus, Akash Makkar, Vijay Swarup

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background: Pocket hematoma is a recognized complication after placement of cardiac implantable electronic devices and is associated with increased device infection, length of hospitalization, and morbidity especially with uninterrupted antiplatelet agents and anticoagulants. We assessed the use of a post-surgical vest to decrease the incidence of pocket hematoma in patients undergoing device implantation with uninterrupted antiplatelet and anticoagulants. Methods: In this observational study, a vest was used by 20 consecutive patients who were compared to 20 age-, gender-, procedure-matched patients who received standard care. All patients were continued on antiplatelet and anticoagulants in the perioperative period. The pocket was assessed at post procedure day 0, 2, and 7, respectively. Results: There were no significant differences in the baseline characteristics between both groups. Baseline mean international normalized ratio (INR) was significantly higher in the vest group when compared with the control group (2.7 ± 0.4 vs. 2.2 ± 0.3 = <0.001). The incidence of pocket hematoma was significantly lower in the vest group than the control group (0 vs 30%, p = 0.02) at the end of 7 days. Control group had a total of six hematomas with one patient requiring evacuation and blood transfusion. The vest group had three hematomas on day 2 that resolved by day 7. Conclusions: The risk of moderate or large pocket hematoma is significantly reduced with the use of this vest in high-risk patients undergoing implantable devices on uninterrupted antiplatelet and anticoagulants.

Original languageEnglish
Pages (from-to)197-204
Number of pages8
JournalJournal of Interventional Cardiac Electrophysiology
Volume49
Issue number2
DOIs
StatePublished - 1 Aug 2017
Externally publishedYes

Keywords

  • Cardiac implantable electronic device
  • Compression vest
  • Device complications
  • Hospital outcomes
  • Pocket hematoma

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