Hemophilia B is an uncommon genetic bleeding disorder characterized by a deficiency of factor IX, and its coexistence with atrial fibrillation creates a clinical challenge since long-term anticoagulation therapy is generally contraindicated. A 65-year-old male with paroxysmal atrial fibrillation and hemophilia B was referred for left atrial appendage (LAA) closure because of his elevated thromboembolic risk and bleeding tendency . Pre-procedural cardiac computed tomography angiography demonstrated the anatomical characteristics of the LAA and assisted in device selection (Figure 1). T ransesophageal echocardiography (TEE) confirmed the absence of thrombus within the LAA before intervention. Under gen-eral anesthesia, a 33 mm Amplatzer(TM) Amulet(TM) device was successfully deployed