Patients with atrial fibrillation requiring anticoagulation treatment are at high risk of gastrointestinal bleeding. The investigators propose the percutaneous stop the oral anticoagulation and closure of the left atrial appendage with the Amplatzer ® system in patients receiving anticoagulant therapy for atrial fibrillation without associated valvular heart disease, to reduce significantly the risk of stroke while minimizing the risk of bleeding in a group of patients with high risk for both events.

ELIGIBLE trial(Left atrial appendage Efficacy of GastroIntestinal Bleeding after closure) is a prospective, multicentric and randomized (2 to 1) trial, comparing percutaneous closure of atrial appendage left versus standard treatment with oral anticoagulants in patients with history of gastrointestinal bleeding and high embolic risk.

Inclusion Criteria:

• documented atrial fibrilation (paroxysmal or permanent) without significant heart valve disease
• > 18 years
• Classic oral anticoagulation(INR at therapeutic levels: 2-3) or New oral anticoagulants
• CHA2-DS2-VASC score ≥ 3
• prior digestive bleeding without any treatable cause
• Informed consent.

Exclusion Criteria:

• POF
• contraindication to further treatment with dual antiplatelet therapy (aspirin + clopidogrel)
• Intracardiac thrombus
• significant carotid disease
• Cardioversion scheduled within 30 days following the implantation
• AF not controlled by FVM> 100 bpm
• AF secondary to surgery or ablation
• thrombosis in patients <40 years
• chronic renal insufficiency with Cr clearance <30 ml 2
• left appendage sizeappendage with inlet <12.6 mm or > 28.5 (ETE)
• depth of the appendage <10mm in the TEE