A 71-year-old on stable warfarin (INR 2.4) for AF needs elective pacemaker implantation. What is the optimal perioperative antithrombotic plan?...

Question

A 71-year-old on stable warfarin (INR 2.4) for AF needs elective pacemaker implantation. What is the optimal perioperative antithrombotic plan?

Accepted Answer

Continue warfarin without interruption

Answer

Stop warfarin 5 days prior and bridge with therapeutic LMWH

Answer

Stop warfarin 3 days prior without bridging

Answer

Switch to a DOAC for 1 week before surgery

Answer

Administer vitamin K 2.5 mg to normalize INR before surgery

us-abim MCQ (SBA): Perioperative Anticoagulation