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https://doi.org/10.14300/mnnc.2023.18089

Influence of pacemaker implantation on the hemostasis system of patients in early postoperative period

[Surgery]
Roman Kalinin; Igor Suchkov; Vladislav O. Povarov; Olga Nikolaevna Zhurina;

The effect of implantation of an electrocardiostimulator (ECS) on the hemostasis system of patients in the early postoperative period was evaluated. The study included 42 patients with indications for ECS implantation. Before and 7 days after surgery, all patients underwent venous blood sampling to determine the markers of the hemostasis system – von Willebrand factor, fibrinogen, blood coagulation factor VIII (FVIII), blood coagulation factor IX (FIX), D-dimer, antithrombin III, protein C. Significant changes were noted for the level of fibrinogen (2.86±0.78 and 3.3±0.75 g/l) and D-dimer (300 (300– 700) and 500 (300–1000) μg/l DDU). 7 days after surgery, the activity of FVIII and FIX was lower in patients with sick sinus syndrome (SSS) compared with patients with permanent atrial fibrillation (AF) (p=0.007 and p=0.008) and atrioventricular block (p=0.017 and p=0.013). ECS implantation leads to a shift in the balance of the hemostasis system towards hypercoagulation, which persists for at least 7 days after surgery, which may increase the risk of thrombotic complications. The most prone to hypercoagulability before and after ECS implantation are patients with permanent AF, the least prone to hypercoagulability are patients with SSS.

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Keywords: cardiac implantable electronic devices, pacemaker, hemostasis system, coagulation