**ICD Implantation Procedure**

**Chapter 7**

**ICD and PM Implantation Procedure:**

**Relevant Periprocedural Issues**

Additional information is available at the end of the chapter

**1.1. Perioperative management of antiplatelet**

dealing with this increasing challenge [5-7].

**1.2. Antiplatelet therapy**

Over the last years implanting physicians are frequently forced to manage perioperative sit‐ uation with increased bleeding risk due to anticoagulation (oral or intravenous) or dual anti‐ platelet therapy. Large number of patients have indication for long term use of oral anticoagulation because of atrial fibrillation, prosthetic heart valves, anamnestic cerebrovas‐ cular accident or recurrent venous thromboembolism. On the other hand an increasing number of patients have indication for dual antiplatelet therapy (DAPT) - mainly after coro‐ nary artery interventions. There is an increased need for a standardized perioperative man‐ agement by either postponing the procedure (if clinically possible), bridging or pausing the therapy or taking the risk of a bleeding complication if inevitable. To help the implanting physician with a reasonable decision, there are guidelines offered by the large cardiology so‐ cieties [1-4] concerning the management of patients with AF, as well as recent publications

Antiplatelet therapy is usually indicated after coronary artery interventions, myocardial in‐ farction as well as extracardial indications including cerebral infarction or peripheral artery disease. Following coronary intervention the need for dual antiplatelet therapy usually is temporally, the duration of therapy depending on the type of stent (bare metal Stent /BMS/ vs. drug eluting stent /DES/) as well as on the stent position and implant indication (acute coronary syndrome vs. elective angioplasty). Following this time period most patients will

> © 2013 Schmitt; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

Joern Schmitt

**1. Introduction**

http://dx.doi.org/10.5772/54203

**and anticoagulation therapy**
