{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:11:53Z","timestamp":1762506713224},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,2,17]],"date-time":"2016-02-17T00:00:00Z","timestamp":1455667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Management of Tamponade Following AF Ablation With FXaI<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Because of the absence of a dedicated reversal agent, the outcome of pericardial effusion (PE) following procedures performed with uninterrupted apixaban or rivaroxaban is unknown. We report the characteristics of PEs presenting with tamponade in patients undergoing AF ablation with uninterrupted factor Xa inhibition (FXaI) to understand their management and prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>We performed a multicenter cross\u2010sectional survey in 10 centers across the United States. Patient data were obtained by chart review. In all patients the procedure was performed with uninterrupted FXaI. A total of 16 PEs requiring intervention were reported from 5 centers. Two patients were on apixaban 5 mg BD, the remaining on rivaroxaban 20 mg OD. Eleven PEs occurred in the periprocedural setting, and 5 PEs occurred from 1 to 28 days after the procedure. Pericardiocentesis and drainage were performed in all cases. Protamine and 4\u2010factor prothrombin complex concentrate (4F\u2010PCC) were given in all periprocedural cases. Two patients required surgery: in one case coagulation of the pericardial blood prevented effective drainage, and in the other bleeding was secondary to a steam pop\u2010induced atrial tear. None of the postprocedural cases required FXaI reversal and the dose of rivaroxaban was temporarily reduced. No fatal outcomes or thromboembolic events were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pericardiocentesis and drainage with FXaI reversal proved effective in the management of acute PEs with tamponade occurring periprocedurally in patients undergoing AF ablation with uninterrupted FXaI. Early postprocedural effusions can be treated with pericardiocentesis without the need of a reversal agent.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.12918","type":"journal-article","created":{"date-parts":[[2016,1,12]],"date-time":"2016-01-12T14:23:38Z","timestamp":1452608618000},"page":"399-403","source":"Crossref","is-referenced-by-count":17,"title":["Management of Periprocedural and Early Pericardial Effusions With Tamponade Following Ablation of Atrial Fibrillation With Uninterrupted Factor Xa Inhibitors: A Case Series"],"prefix":"10.1111","volume":"27","author":[{"given":"CAROLA","family":"GIANNI","sequence":"first","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center  Austin Texas USA"},{"name":"Department of Clinical Sciences and Community Health University of Milan  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LUIGI","family":"DI BIASE","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center  Austin Texas USA"},{"name":"Montefiore Medical Center Albert Einstein College of Medicine  Bronx NY USA"},{"name":"Department of Biomedical Engineering University of Texas  Austin Texas USA"},{"name":"Department of Clinical and Experimental Medicine University of Foggia  Foggia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SANGHAMITRA","family":"MOHANTY","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CHINTAN","family":"TRIVEDI","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RONG","family":"BAI","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AMIN","family":"AL\u2010AHMAD","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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