Atrial fibrillation (AF), a common cardiac arrhythmia associated with
increased risk of heart failure, thromboembolic phenomena and death, is a leading
cause of hospitalization of adults. A major complication of AF is an increased risk of
ischemic stroke leading to long-term disability and in severe cases, death.
Historically, Coumadin has been the drug of choice for chronic anticoagulation and
stroke prevention in AF patients however, given the need for constant monitoring and
multiple drug interactions, newer anticoagulants have been developed. One such drug
is dabigatran, with the promise of less frequent monitoring and decreased bleeding
tendencies as compared to Coumadin. The main disadvantage of dabigatran has been
the lack of a reversal agent in case of severe bleeding or emergent surgical
intervention. This was until the recent The Food and Drug Administration approval of idarucizumab, a
potential reversal agent for dabigatran. In this article, we discuss the evidence addressing idarucizumab
safety, tolerability and its efficacy for reversing effect of dabigatran.
Keywords: Atrial fibrillation, bleeding, dabigatran, hemostasis, idarucizumab, reversal agent.
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