Devemos suspender os agentes antiagregantes plaquetários para procedimentos de dispositivos cardíacos implantáveis

Resumo: A cardiopatia isquemica esta comumente associada a arritmias ventriculares malignas, sendo o cardiodes fibrilador implantavel indicado para pacientes selecionados. Essa populacao faz uso de agentes antiagregantes plaquetarios como terapia unica ou com duas medicacoes combinadas. Embora fundamentais para o tratamento da coronariopatia, os antiagregantes plaquetarios aumentam o risco de sangramento nesses pacientes, em especial ao se tratar de intervencao cirurgica. Os autores relatam o caso de paciente portador de desfibrilador cardiaco implantavel e cardiopatia isquemica, que precisou suspender o uso de antiagregantes plaquetarios em decorrencia de indicacao cirurgica de troca da unidade geradora por desgaste de bateria. Apos suspensao da dupla antiagregacao, o paciente apresentou choque apropriado decorrente de fibrilacao ventricular secundaria a trombose aguda intrastent. Descritores: Cardiodesfibriladores Implantaveis; Estimulacao Cardiaca Artificial; Morte Subita; Fibrilacao Ventricular; Inibidores da Agregacao de Plaquetas; Stents; Procedimentos Cirurgicos Operatorios.

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