Clinical significance of gastrointestinal bleeding history in patients who undergo left atrial appendage closure

Background and AimAnticoagulant users with nonvalvular atrial fibrillation (NVAF) sometimes suffer from gastrointestinal bleeding (GIB) and have difficulty continuing the medication. Left atrial appendage closure (LAAC) has been developed for such situations. We aimed to clarify the clinical significance of a history of GIB in comparison to other factors in patients who had undergone LAAC.MethodsFrom October 2019 to September 2023, patients with NVAF who underwent LAAC at our hospital were enrolled. We investigated the percentage of patients with a history of GIB who underwent LAAC and compared the incidence of post-LAAC bleeding in these patients compared to those with other factors.ResultsA total of 45 patients were included. There were 19 patients (42%) with a history of GIB who underwent LAAC. In a Kaplan-Meier analysis, the cumulative incidence of bleeding complications after LAAC was significantly higher in patients with a history of GIB in comparison to patients with other factors. There were eight cases of post-LAAC bleeding in total, and seven cases had GIB.ConclusionsWe need to recognize that GIB is a significant complication in patients who undergo LAAC. The management of GIB by gastroenterologists is essential to the success of LAAC. This study was aimed to clarify the clinical significance of a history of gastrointestinal bleeding (GIB) in patients who underwent left atrial appendage closure (LAAC). The risk of rebleeding after LAAC was significantly higher in patients with a history of GIB in comparison to patients with other factors. LAAC is an important option for managing gastrointestinal bleeding in patients taking anticoagulants.image