The most severe complications are stroke (<1%) and pericardial tamponade (1–2%).4The incidence of clinical relevant groin hematoma after PVI in the general population is 0.9%.9In our group it is likely that the combination of therapeutic LMWH, VKA therapy, decreased FVIII levels and mobilization shortly after the procedure have caused the high bleeding rate (25%). The gene discussed is F8; the disease is cardiac tamponade.