Perioperative management of patients undergoing electrophysiology procedures is challenging, as many of these patients have a high underlying embolic risk and are often on oral anticoagulant therapy.The decision to continue or discontinue oral anticoagulation, or order bridging therapy, is controversial.This article aims to generate evidence-based recommendations for the perioperative management of anticoagulation in patients who, due to their embolic risk, require oral anticoagulation and will undergo cardiac pacing device implantation or arrhythmia ablation.A systematic review has been carried out following the criteria of the PRISMA protocol.The search was performed in the MEDLINE-PubMed, Embase, Cochrane, Google Scholar, NICE, Epistemonikos and LILACS databases.This systematic review included clinical practice guidelines, systematic reviews of the literature, and meta-analyses.The evidence was updated from January 1, 2014, to February 28, 2022.Three clinical practice guidelines (CPGs) and four systematic literature reviews (SLRs) were taken as a body of evidence, which were scored with the AGREE II and AMSTAR II tools, respectively.Evidence-based recommendations, using the GRADE methodology, are generated which highlight that oral anticoagulation with vitamin K antagonists should be ordered continuously for both atrial fibrillation (AF) ablation and device implantation; however, there is not much evidence on direct oral anticoagulation in device implantation.