# Hemorrhagic Pericardial Effusion and Gastrointestinal Bleed After Atrial Fibrillation Epicardial Ablation: A Case Report

## TL;DR

A man developed heart and stomach complications after a cardiac procedure, requiring urgent treatment and highlighting the need for careful management.

## Contribution

This case report highlights the rare but critical complications following atrial fibrillation ablation and appendage ligation.

## Key findings

- Patient developed hemorrhagic pericardial effusion and gastrointestinal bleeding post-procedure.
- Management included pericardiocentesis and anticoagulation reversal.
- Case emphasizes the need for early recognition and multidisciplinary care.

## Abstract

A 47‐year‐old male with persistent atrial fibrillation presented with melena and presyncope 3 weeks after epicardial ablation and left atrial appendage ligation. He was found to have hemorrhagic pericardial effusion with tamponade physiology and gastrointestinal bleeding from a clean‐based duodenal ulcer. Management included pericardiocentesis, anticoagulation reversal, and stabilization. This case underscores the interplay between cardiac tamponade and GI bleeding, highlighting the importance of early recognition and multidisciplinary management.