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Plasma Exchange for Urgent Apixaban Reversal in a Case of Hemorrhagic Tamponade after Pacemaker Implantation

Wilson W Lam, Meredith A Reyes, John J Seger

    Texas Heart Institute Journal
    |September 29, 2015
    PubMed

    We report the case of an 82-year-old man in whom hemorrhagic pericardial effusion occurred one week after pacemaker implantation, while he was taking apixaban. Few therapies exist for reversing the anti-Xa effect of apixaban. To reverse anticoagulation, our patient underwent plasma exchange, which facilitated pericardiocentesis and prevented possible surgical intervention. To our knowledge, this is the first report of the use of plasmapheresis to reverse the anticoagulant effect of apixaban.

    Keywords:
    Anticoagulants/administration & dosage/adverse effects/antagonists & inhibitors/therapeutic useapixabanatrial fibrillation/complications/drug therapyfactor Xa inhibitorspacemaker, artificial/adverse effectsplasma exchangerisk factorsstroke/prevention & controltreatment outcomewarfarin/therapeutic use

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