Bed rest after cardiovascular implantable electronic device placement: Systematic review and meta-analysis

Background. Bed rest is prescribed for all patients after cardiovascular implantable electronic device (CIED) placement but to a varied extent. Different clinical protocols exist. Aim. To assess the effects of different lengths of bed rest on complications and patient comfort after CIED implantation. Methods. We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CINAHL, SCOPUS. We included randomized and quasi-randomized controlled trials. Two of the authors independently selected trials, assessed the risk of bias, and extracted data. Results. We included 2 RCTs. There was no evidence that shorter bed rest was more harmful than longer bed rest in terms of lead displacement (RR 0.681, 95% CI [0.063, 7.332]) and hematoma (RR 1.642, 95% CI [0.282, 9.560]). None of the studies reported the assessment of bleeding, back pain, or urinary discomfort. Conclusions. Shorter periods of bed rest appear to be as safe as longer ones. However, to confirm these results, further larger trials are needed.