Operating without Warfarin decreases risks in cardiac device surgery

Operating without Warfarin reduces the dangers of cardiac device surgery, a new study has found.

These findings of the Bruise Control Trial were released by the University of Ottawa at Heart Rhythm 2013, the Heart Rhythm Society’s 34th Annual Scientific Sessions, with the results set to be published in the New England Journal of Medicine.

A minimum of a quarter of patients requiring pacemaker or implantable defibrillator surgery are taking warfarin to decrease the risk of a stroke, with current guidelines recommending patients to be bridged to heparin treatment in the days leading up to surgery, putting patients at risk of a stroke.

The Bruise Control trial is the largest randomised clinical trial to compare continuing warfarin to temporary cessation with heparin bridging in patients before and following surgery.

Results showed that, compared to the heparin arm of the trial, patients receiving warfarin endured fewer extended hospital stays - 1.2 per cent, in comparison to 4.8 per cent.

David Birnie, director of the Arrhythmia Service at the University of Ottawa Heart Institute, said: “We hope that Bruise Control will change how we are treating patients around the world. Our study conclusively shows that treating patients with a high risk of stroke with continued warfarin instead of heparin bridging will improve patient outcomes, decrease complications and reduce hospitalisation.”

Dr Jean Rouleau, scientific director of the CIHR Institute of Circulatory and Respiratory Health, also commented on the results, stating that the randomised clinical trial shows that patients requiring cardiac arrhythmia device surgery can remain on their existing blood thinners, decreasing the chance of stroke and hematoma.

“CIHR is pleased to support Dr. Birnie and his team. Our hope is that this research evidence will soon be brought to the point of care, so it can benefit patients around the world,” Dr Rouleau explained.