Left Atrial Appendage Occlusion as an Alternative to Anticoagulants in Ibrutinib-Induced Hemorrhagic Pericardial Effusion.

Bleeding tendency increases with concomitant use of ibrutinib and anticoagulants. Our patient presented with shortness of breath and was found to have a nonmalignant hemorrhagic pericardial effusion. Ibrutinib was resumed, and percutaneous left atrial appendage occlusion was performed as a substitute for the chemical anticoagulation to decrease the drug-drug interaction. (Level of Difficulty: Intermediate.).