Randomized Study of the Use of Warfarin During Pacemaker or ICD Implantation in Patients Requiring Long Term Anticoagulation
Bradycardia, Tachycardia, Atrial Fibrillation
About this trial
This is an interventional prevention trial for Bradycardia focused on measuring bleeding, anticoagulation, pacemaker, implantable cardioverter-defibrillator, patients undergoing implantation of a pacemaker or defibrillator (ICD)"
Eligibility Criteria
Inclusion Criteria:
- scheduled for clinically indicated permanent pacemaker or implantable cardioverter-defibrillator
- currently on chronic warfarin therapy
Exclusion Criteria:
- unwilling to participate in trial
Sites / Locations
- Johns Hopkins Bayview Medical Center
- Howard County General Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Active Comparator
Experimental
Active Comparator
1
2
3
4
Moderate risk patients (afib, mechanical aortic valve) randomized to continue coumadin at their usual dose through the procedure.
Moderate risk patients randomized to hold their coumadin for 4-5 days prior to the procedure (to allow the INR to normalize).
High risk patients (mechanical mitral valve, prior stroke, current deep vein thrombosis, hypercoagulable syndrome) randomized to continue coumadin at the usual dose through the procedure.
High risk patients randomized to holding coumadin for 4-5 days and using "bridging" anticoagulation with heparin while the coumadin is held.