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LETTER TO THE EDITOR

Rivaroxaban-induced hemorrhagic pericardial tamponade in endstage renal disease Nicole Rapista1 · Sauradeep Sarkar1 · Rahul Chaudhary2,3 

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Highlights  • Rivaroxaban does not have FDA approval for use in non-

valvular atrial fibrillation in patients with ESRD.

• There has been increased off-label use of rivaroxaban in

this population.

• We present a case of hemorrhagic pericardial tamponade

with rivaroxaban use in a patient with NVAF and ESRD.

• We recommend a thorough risk-benefit analysis before

the choice of anticoagulant in this patient population.

To the Editor, Approximately 12% of patients with non-valvular atrial fibrillation (NVAF) have creatinine clearance 

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