Do patients with pacemakers need anticoagulation

Current guidelines suggest to stop warfarin treatment 3–4 days before the procedure, to perform the procedure once the INR is <1.8, and resume warfarin 12–24 h later [25], [34].

Patients requiring long term anticoagulation often undergo transition of their warfarin to heparin in anticipation of invasive surgical procedures such as pacemaker or ICD implantation.

Each year, an estimated 1.25 million pacemakers and 410 000 implantable cardioverter-defibrillators are implanted worldwide. Clinical trials suggest that ≈25% of pacemaker and 35% of implantable cardioverter-defibrillator patients receive long-term oral anticoagulation (OAC). 20 May 2014

TUESDAY, Oct. 18, 2016 (HealthDay News) — People with an abnormal heart rhythm called atrial fibrillation typically take powerful blood thinners to prevent strokes. But, some patients who have implanted pacemakers or defibrillators may not always need the drugs , a new study suggests.

For most patients with atrial fibrillation (AF) with an indication for anticoagulation, we recommend a direct oral anticoagulant (DOAC) rather than a vitamin K antagonist (VKA; eg, warfarin) (Grade 1A). (See ‘Choice of anticoagulant’ above.)