left atrial appendage closure: a balanced management of the thromboembolic risk in patients with hemophilia and atrial fibrillation

Atrial fibrillation is the most common cardiac arrhythmia and is a major cause of embolic stroke. in patients at high bleeding risk such as those with hemophilia, the thromboembolic prevention is challenging. we herein present three patients affected by moderate to severe hemophilia and atrial fibrillation that were treated in our institution between 2018 and 2019, with percutaneous left atrial appendage closure. in patients with relative or absolute contraindications to long-term anticoagulant therapy, the left atrial appendage closure could represent a reasonable strategy.