{"?xml":{"@version":"1.0"},"edm:RDF":{"@xmlns:dc":"http://purl.org/dc/elements/1.1/","@xmlns:edm":"http://www.europeana.eu/schemas/edm/","@xmlns:wgs84_pos":"http://www.w3.org/2003/01/geo/wgs84_pos","@xmlns:foaf":"http://xmlns.com/foaf/0.1/","@xmlns:rdaGr2":"http://rdvocab.info/ElementsGr2","@xmlns:oai":"http://www.openarchives.org/OAI/2.0/","@xmlns:owl":"http://www.w3.org/2002/07/owl#","@xmlns:rdf":"http://www.w3.org/1999/02/22-rdf-syntax-ns#","@xmlns:ore":"http://www.openarchives.org/ore/terms/","@xmlns:skos":"http://www.w3.org/2004/02/skos/core#","@xmlns:dcterms":"http://purl.org/dc/terms/","edm:WebResource":[{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-NEAAKIG4/584078e1-d371-4ecd-b40a-04af06301412/PDF","dcterms:extent":"728 KB"},{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-NEAAKIG4/55843f1b-572c-42fb-ae82-ebb5b9862630/TEXT","dcterms:extent":"35 KB"}],"edm:TimeSpan":{"@rdf:about":"1929-2026","edm:begin":{"@xml:lang":"en","#text":"1929"},"edm:end":{"@xml:lang":"en","#text":"2026"}},"edm:ProvidedCHO":{"@rdf:about":"URN:NBN:SI:doc-NEAAKIG4","dcterms:isPartOf":[{"@rdf:resource":"https://www.dlib.si/details/urn:nbn:si:spr-a30mfzkp"},{"@xml:lang":"sl","#text":"Zdravniški vestnik"}],"dcterms:issued":"2023","dc:creator":["Alatič, Jan","Jan, Matevž","Kšela, Juš","Miklič, Marko","Naji, Franjo","Vokač, Damijan","Zupan, Anja","Žižek, David"],"dc:contributor":"Zupan, Anja","dc:format":[{"@xml:lang":"sl","#text":"številka:5/6"},{"@xml:lang":"sl","#text":"letnik:92"},{"@xml:lang":"sl","#text":"str. 275-282"}],"dc:identifier":["DOI:10.6016/ZdravVestn.3402","ISSN:1318-0347","COBISSID:159733251","URN:URN:NBN:SI:doc-NEAAKIG4"],"dc:language":"en","dc:publisher":{"@xml:lang":"sl","#text":"Slovensko zdravniško društvo"},"dc:subject":[{"@xml:lang":"sl","#text":"antiagregacijska zdravila"},{"@xml:lang":"en","#text":"antiplatelets"},{"@xml:lang":"en","#text":"cardiac pacemaker"},{"@xml:lang":"en","#text":"device complications"},{"@xml:lang":"sl","#text":"hematom ležišča"},{"@xml:lang":"en","#text":"perioperative anticoagulation"},{"@xml:lang":"sl","#text":"perioperativno antikoagulantno vodenje"},{"@xml:lang":"en","#text":"pocket hematoma"},{"@xml:lang":"sl","#text":"srčni spodbujevalnik"},{"@xml:lang":"sl","#text":"zapleti vsadne naprave"}],"dcterms:temporal":{"@rdf:resource":"1929-2026"},"dc:title":{"@xml:lang":"sl","#text":"Antithrombotic management in patients undergoing cardiac implantable electronic device implantation| Antitrombotično zdravljenje pri bolnikih pred vstavitvijo vsadne elektrostimulacijske naprave srca|"},"dc:description":[{"@xml:lang":"sl","#text":"Cardiac implantable electronic devices (CIEDs) are an established treatment option for arrhythmias, sudden cardiac death prevention, and heart failure. Approximately 1000 devices are implanted per million inhabitants in European countries each year. However, the main concern in patients with an indication for CIED implantation is frequently associated with comorbidities requiring antithrombotic medications. The invasive device implantation procedure represents a bleeding risk ranging from pocket hematoma to cardiac tamponade. On the other hand, temporary interruption of antithrombotic therapy increases the risk for thromboembolic events. Implanting CIEDs in patients on antithrombotic medications incites several clinical dilemmas of balancing thromboembolic risk against bleeding risk, as complications are associated with higher mortality rates in both aspects. The most common bleeding complication is pocket haematoma formation, which is associated with a prolonged hospital stay, higher cost, higher risk of pocket infection, and thus higher morbidity and mortality. Studies have shown that the heparin bridging strategy in patients on oral anticoagulants imposes a greater risk for pocket haematoma formation and no benefit in reducing thromboembolic events. Most procedures of CIED implanta-tion can be performed safely with uninterrupted oral anticoagulants. Dual antiplatelet therapy increases the risk of pocket haematoma and should be avoided whenever possible"},{"@xml:lang":"sl","#text":"Vsadne elektrostimulacijske naprave so pomemben del zdravljenja malignih aritmij, srčnega popuščanja in preprečevanja nenadne srčne smrti. Letno se v evropskem prostoru vstavi približno 1.000 naprav na milijon prebivalcev. Glavna težava pri bolnikih, pri katerih je predvidena vstavitev elektrostimulacijske naprave, so pridružene bolezni, pri katerih je potrebno antitrombotično zdravljenje. Poseg pomeni povečano tveganje za krvavitev, ki se pri vsadnih elektrostimulacijskih napra-vah pokaže vse od hematoma v področju ležišča naprave do tamponade srca. Drugi del spektra tveganj pa je nevarnost, da nastopi trombembolični dogodek zaradi prehodne prekinitve antitrombotičnega zdravljenja. Antitrombotično zdravljenje v obdobju ob posegu pa pomeni pomembno klinično dilemo pri obravnavi tovrstnih bolnikov. Najpogostejši zaplet je he-matom v ležišču naprave, ki terja daljšo hospitalizacijo, višje stroške in večje tveganje za okužbo ležišča, kar vodi do večje obolevnosti in smrtnosti. Prvotno so za preprečevanje morebitnih trombemboličnih dogodkov priporočali premostitev antitrombotične terapije s heparinom, vendar so kasneje raziskave pokazale, da ta strategija prinaša večje tveganje za hematom v ležišču naprave v primerjavi ali z neprekinjenim ali s kratkoročno prekinjenim peroralnim antitrombotičnim zdravljenjem. Hkrati niso opažali pomembne razlike v pojavnosti trombemboličnih dogodkov med obema skupinama bolnikov. Trenutno veljavna priporočila odsvetujejo premostitveno zdravljenje s heparini v obdobju ob posegu. Večino vstavitev vsadnih elektrostimulacijskih naprav lahko varno opravimo ob strategiji neprekinitve prejemanja peroralnega antikoagulacijskga zdravljenja. Dvojna antiagregacijska terapija pa je povezana s povečanim tveganjem za hematom leži-šča naprave in se zato odsvetuje v obdobju ob posegu, če je to sploh mogoče"}],"edm:type":"TEXT","dc:type":[{"@xml:lang":"sl","#text":"znanstveno časopisje"},{"@xml:lang":"en","#text":"journals"},{"@rdf:resource":"http://www.wikidata.org/entity/Q361785"}]},"ore:Aggregation":{"@rdf:about":"http://www.dlib.si/?URN=URN:NBN:SI:doc-NEAAKIG4","edm:aggregatedCHO":{"@rdf:resource":"URN:NBN:SI:doc-NEAAKIG4"},"edm:isShownBy":{"@rdf:resource":"http://www.dlib.si/stream/URN:NBN:SI:doc-NEAAKIG4/584078e1-d371-4ecd-b40a-04af06301412/PDF"},"edm:rights":{"@rdf:resource":"http://creativecommons.org/licenses/by-nc/4.0/"},"edm:provider":"Slovenian National E-content Aggregator","edm:intermediateProvider":{"@xml:lang":"en","#text":"National and University Library of Slovenia"},"edm:dataProvider":{"@xml:lang":"sl","#text":"Slovensko zdravniško društvo"},"edm:object":{"@rdf:resource":"http://www.dlib.si/streamdb/URN:NBN:SI:doc-NEAAKIG4/maxi/edm"},"edm:isShownAt":{"@rdf:resource":"http://www.dlib.si/details/URN:NBN:SI:doc-NEAAKIG4"}}}}