{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:08:32Z","timestamp":1784030912595,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Concomitant atrial fibrillation (AF) and gastrointestinal (GI) bleeding present a clinical challenge due to recurrent bleeding risk associated with anticoagulation for AF\u2010associated stroke prevention. Left atrial appendage occlusion (LAAO) offers an alternative stroke prevention strategy, but its impact on recurrent GI bleeding remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, multicenter cohort study used the TriNetX database to identify adults with AF on oral anticoagulation and a history of GI bleeding. Patients were stratified by treatment with or without LAAO. 1:1 propensity score matching (PSM) was employed. The primary outcome was recurrent GI bleeding. Cox regression analysis was used to generate hazard ratios (HRs) with 95% confidence intervals (CIs). Odds ratios (ORs) were used to evaluate effect sizes between groups. Kaplan\u2013Meier curves were used for time\u2010to\u2010event analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After PSM, 9259 patients were compared in each group. Odds of recurrent GI bleeding were consistently lower in patients undergoing LAAO than without LAAO across all follow\u2010up intervals: at 3 months (OR 0.84; 95% CI 0.78\u20130.91), 6 months, 1 year, 3 years, and 5 years (OR 0.87; 95% CI 0.82\u20130.92). Kaplan\u2013Meier analysis demonstrated significantly lower risk of recurrent GI bleeding with LAAO (HR 0.80; 95% CI 0.76\u20130.84;\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with AF and prior GI bleeding, LAAO was associated with a significantly lower risk of recurrent GI bleeding at short\u2010term and long\u2010term time intervals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70177","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T14:00:54Z","timestamp":1771682454000},"page":"898-910","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent Gastrointestinal Bleeding in Patients With Atrial Fibrillation Treated With Left Atrial Appendage Occlusion"],"prefix":"10.1111","volume":"49","author":[{"given":"Adham","family":"Ramadan","sequence":"first","affiliation":[{"name":"Department of Medicine Boston Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1915-0174","authenticated-orcid":false,"given":"Mohamed","family":"Doma","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Massachusetts General Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9613-2563","authenticated-orcid":false,"given":"Iuri","family":"Ferreira Felix","sequence":"additional","affiliation":[{"name":"Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Kamel","sequence":"additional","affiliation":[{"name":"Department of Medicine Boston Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud Samy","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Corewell Health William Beaumont University Hospital  Troy Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6595-7856","authenticated-orcid":false,"given":"Ahmed K.","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Department of Medicine Boston Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Ismayl","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehia","family":"Karara","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Alexandria Faculty of Medicine  Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro A.","family":"Villablanca","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Henry Ford Hospital  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Saw","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Vancouver General Hospital University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8420-4670","authenticated-orcid":false,"given":"Christopher V.","family":"DeSimone","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Goldsweig","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, 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