title: Can the vicious cycle of obscure or intractable gastrointestinal bleeding be broken in patients with atrial fibrillation subject to anticoagulant therapy?
abstract: Gastrointestinal bleeding of obscure origin or with an intractable cause is particularly common in patients with atrial fibrillation subject to oral anticoagulant therapy. This condition is highly recurrent and therefore gives rise to high morbidity and mortality rates, thus entailing a vicious cycle that is difficult to solve.Percutaneous left atrial appendage closure has become a therapeutic alternative for patients with atrial fibrillation and a contraindication for oral anticoagulation. This technique would allow the discontinuation of oral anticoagulants, thus helping to reduce the risk for gastrointestinal bleeding, and would also be protective against embolic events in this group of patients, thereby eventually breaking this vicious cycle.We report our experience with percutaneous left atrial appendage closure in the management of patients with atrial fibrillation who are subject to oral anticoagulation therapy and suffer from obscure or intractable gastrointestinal bleeding.
authors.forename: Diego
authors.initials: D
authors.lastname: Fernández-Rodríguez
authors.forename: Victoria
authors.initials: V
authors.lastname: Martín-Yuste
authors.forename: Faust
authors.initials: F
authors.lastname: Feu
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.forename: Xavier
authors.initials: X
authors.lastname: Freixa
authors.forename: Ander
authors.initials: A
authors.lastname: Regueiro
authors.forename: Manel
authors.initials: M
authors.lastname: Sabaté
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D020517:Atrial Appendage / Q000601:surgery; D001281:Atrial Fibrillation / Q000150:complications*; D004617:Embolism / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000628:therapy*; D006801:Humans; D008297:Male; D055989:Septal Occluder Device
chemical_list: D000925:Anticoagulants