First report of dabigatran reversal in iatrogenic pericardial tamponade during catheter ablation of atrial fibrillation

Abstract

Catheter ablation of atrial fibrillation (AF) is recommended for the management of symptomatic paroxysmal or persistent AF. Iatrogenic pericardial tamponade is a well-described potential complication of AF ablation. Pericardial tamponade has been reported to be a complication of 1%–2% of AF ablation procedures. The recently published RE-CIRCUIT study supports the value of performing AF ablation on uninterrupted dabigatran to minimize bleeding and stroke risk.5 Idaracizumab is an approved and widely available monoclonal antibody fragment that has been shown to bind dabigatran and reverse its anticoagulant effect.6 Herein, we report the first use of idaracizumab to reverse the anticoagulant effect of dabigatran in the management of iatrogenic pericardial tamponade during AF ablation.

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Citation
Miller JD et al. Heart Rhythm Case Rep. 2017;3:566–567. eCollection, December, 2017.