Antrum vein ectasia or GAVE syndrome, although rare, can lead to bleeding from the upper gastrointestinal tract in 4% of elderly patients. Its main manifestation includes refractory anemia, requiring regular blood transfusions and constant intake of iron supplements. It is diagnosed by presence of longitudinally located ectatic veins of the antrum of the stomach and histological examination data. Standard treatment includes endoscopic argon plasma coagulation. We present a clinical case report of an elderly woman with GAVE syndrome, severe recurrent iron deficiency anemia, and implanted permanent pacemaker. The treatment complexity in this case was presented by underestimating the endoscopic findings in the gastric mucosa at the onset of the disease, which made it difficult to find the source of bleeding, and the presence of a permanent pacemaker in the patient required correction of its work before the argon plasma coagulation procedure. © 2023, LLC MMA MediaMedika. All rights reserved.