Purpose: In October of 2010, the FDA approved dabigatran etexilate to prevent thromboembolic events in patients with atrial fibrillation (AF). There is a paucity of data to evaluate the risk of periprocedural complications (PC) in patients undergoing an AF ablation using dabigatran as the anticoagulation agent. Methods: We retrospectively reviewed 422 charts of patients with persistent or paroxysmal AF who underwent a radiofrequency ablation from January of 2011 to January 2012 at our institution. We placed patients into groups based on their peri-procedural anticoagulation strategy; warfarin continued (WC) (185 patients), warfarin held (WH) (153 patients), and peri-procedural dabigatran (D) (84 patients). All patients with subtherapeutic INRs after holding warfarin were treated with bridging lovenox. We categorized PC events as major (thromboembolic event or tamponade) or minor (non-life threatening bleeding). All PC events that occurred within 30 days of the AF ablation were counted. Results: In the WC group 23 patients (12.4%) had PCs (20 minor and 3 major), in the WH group 16 patients (10.5%) had PCs (11 minor and 5 major) and in the D group 4 patients (4.8%) had PCs (3 minor and 1 major). For the D and WH groups anticoagulation was held an average of 1 and 1.9 days prior to the procedure respectively. Of the 9 major complications, 5 patients had pericardial tamponade, 3 had a TIA or stroke, and 1 patient had a MI. Of the 34 minor complications, 24 patients had a groin hematoma, 2 had hemoptysis, 1 had a spontaneous orbital hematoma, 3 had a GI bleed, 1 had a small pericardial effusion, and 3 had hematuria. Each anti-coagulation group had comparable amount of patients with paroxysmal and persistent AF (p = NS). There was no difference in the rate of major or minor PCs between any of the anticoagulation groups (p = 0.67 and 0.39 for D vs WC for major and minor PC respectively and p = 0.99 and p = 0.06 for D vs WH for major and minor PCs respectively). Conclusions: Dabigatran is becoming a widely used medication for patients with AF, but little is known about the risk of PCs for patients using dabigatran around the time of an AF ablation. In our series of 422 patients there was no difference in the rate of major or minor PCs for patients on periprocedural dabigatran as compared to warfarin based anti-coagulation strategies.