Abstract
Pericardial bleeding is a rare but life-threatening complication of atrial fibrillation (AF) ablation. When significant pericardial bleeding occurs, protamine should be given to reverse heparin and pericardiocentesis performed. Patients taking uninterrupted oral anticoagulation (AC) are at increased risk for refractory pericardial bleeding. In such cases, andexanet alfa, a recombinant, inactive form of factor Xa, can be given to reverse oral AC. Clinical experience with andexanet in this setting has not yet been reported.
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