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.