Operators and procedure
bleeding, embolic events, CIED, chronic kidney disease
BLEEDING
The procedures were performed in a tertiary care centre by three cardiac electrophysiologists. Each operator had greater than 5 years of experience in CIED implantation with CVC and SVP, and greater than 1 year of experience with IPUS-AVP (over 400 IPUS-AVP procedures in total). Fellows and trainees could participate in the intervention but never as a primary operator.Procedures could be urgent (unplanned admission) or scheduled. Peri-procedural antithrombotic treatment management was left to the operator’s discretion. Usually, in our centre, vitamin K antagonists are maintained with an International Normalized Ratio (INR) in the therapeutic range. According to guidelines, direct oral anticoagulants are generally stopped the day before the procedure (12 or 24 h, depending on the treatment) and resumed the day after, or sometimes two days after in case of high bleeding risk (elderly patients, chronic kidney disease, combination with antiplatelet therapy) in patients without previous embolic events.