Catheter ablation of atrial fibrillation (AF) is associated with cardiac tamponade in between 0.1% and 2.4% of patients when performed in experienced centers. In the vast majority of cases, the tamponade can be managed conservatively; however, occasionally, urgent sternotomy and open repair are needed. In this report, we describe two techniques for pericardial drainage in patients who, without their use, would almost certainly have required an open exploration and surgical repair.