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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, RESULTS. Meshes: Aged, Anticoagulants, Atrial Fibrillation, Case-Control Studies, Female, Heart Valve Prosthesis, Hemorrhage, Heparin, Humans, Incidence, Logistic Models, Male, Pacemaker, Artificial, Postoperative Period, Retrospective Studies.
user
Does post-operative use of heparin increase morbidity of pacemaker implantation? Context: The objective of this study is to characterize the incidence of peri-operative severe adverse events (AEs) related to the post-operative use of heparin in patients undergoing pacemaker surgery. We retrospectively compared the outcome of 38 patients with mechanical valves (MVs) and 76 patients with atrial fibrillation (AF) with control cases matched for gender, age, and surgical details. Heparin was systematically used post-operatively in MV patients, but left to clinical judgment in AF patients. The relative risk for severe haemorrhagic AEs was 11 (CI 1.5-81.1, P < 0.01) in the MV group when compared with matched controls and 8 (CI 1.0-62.5, P < 0.05) in the AF group. Overall, the relative risk of heparin use in the post-operative period was 14 (CI 1.88-104, P = 0.0006) and the post-operative stay was prolonged from 7 days in this group when compared with control cases (P < 0.0001).The variables associated with haemorrhage were the delay to restart heparin after surgery and the presence of an MV.
assistant
Post-operative use of heparin increases morbidity of pacemaker implantation. A different approach to management of these patients is possible. Final Decision: yes