Abstract Number: Esoc2026a709 Effects of Percutaneous Left Atrial Appendage Closure for Atrial Fibrillation in Patients With Intracerebral Hemorrhage: A Pooled Analysis of Individual-Patient Data From Cohort Studies

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Intracerebral hemorrhage and atrial fibrillation (n=241). Intervention: Percutaneous left atrial appendage closure (LAAC). Primary outcome: Serious vascular events (composite of non-fatal stroke, non-fatal myocardial infarction, or vascular death) (Incidence rate per 100 person-years, 95% CI 3.14-6.65).

Nicolas Raposo; Romain Eschalier; A. SALIMBENI; Marianne Lepetit; Alexis Ducos; Clémence Blanc; Paul Guedeney; François Brigadeau; Anna Ferrier; Meyer Elbaz

doi:10.1093/esj/aakag023.403

May 1, 2026European Stroke JournalOpen Access

Abstract Number: Esoc2026a709 Effects of Percutaneous Left Atrial Appendage Closure for Atrial Fibrillation in Patients With Intracerebral Hemorrhage: A Pooled Analysis of Individual-Patient Data From Cohort Studies

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Key result

LAAC in patients with AF and ICH demonstrates ~4.7 serious vascular events per 100 person-years.

Incidence rate per 100 person-years
95% CI 3.14-6.65
n=241

Why the study?

Optimal preventive strategy in ICH survivors with AF is a clinical dilemma, and data on the effects and safety of LAAC in individuals with ICH are limited.

Key Points

This analysis aims to assess the safety and impact of left atrial appendage closure in patients suffering from atrial fibrillation and intracerebral hemorrhage.
Conducted a pooled analysis of individual-patient data from cohort studies at 6 sites in France
Included 241 patients with atrial fibrillation and a history of intracerebral hemorrhage
Measured risks of recurrent intracerebral hemorrhage, ischemic stroke, serious vascular events, and procedural complications
Procedural complications occurred in 9 patients (3.73%)
Incidence rates per 100 person-years were 3.15 for recurrent ICH (95% CI, 1.95-4.82), 2.46 for ischemic stroke (95% CI, 1.40-3.99), and 4.66 for serious vascular events (95% CI, 3.14-6.65)
Findings suggest that LAAC is safe for ICH patients with AF

Study Design

Type

Cohort (n=241)

Multicenter

Yes

Structured PICO

P

Population

241 survivors of intracerebral hemorrhage (ICH) with atrial fibrillation (AF), mean age 76.8, 37% women, from 4 sites in France.

I

Intervention

Percutaneous left atrial appendage closure (LAAC)

O

Outcome

Absolute risks of recurrent ICH, ischemic stroke, any serious vascular events (composite outcome of non-fatal stroke, non-fatal myocardial infarction, or vascular death), and procedural complicationscomposite

Main Result

Effect estimate: Incidence rate per 100 person-years (95% CI 3.14-6.65)

In survivors of intracerebral hemorrhage with atrial fibrillation, left atrial appendage closure appears safe with acceptable rates of recurrent ICH and ischemic stroke.

Implication

Guides clinical risk-benefit assessment for antithrombotic therapy after ICH; extends randomized evidence on long-term recurrent ICH rates.

Abstract

Background and aims Optimal preventive strategy in survivors of intracerebral hemorrhage (ICH) who also have atrial fibrillation (AF) is a long-standing clinical dilemma. Left atrial appendage closure (LAAC) has emerged as a promising treatment but data in individuals with ICH are limited. This study aimed to evaluate the effects and safety of LAAC in these patients. Methods We conducted a pooled analysis of individual-patient data from cohorts of ICH survivors with AF treated with LAAC in 6 sites in France. We measured the absolute risks of recurrent ICH, ischemic stroke, and any serious vascular events (composite outcome of non-fatal stroke, non-fatal myocardial infarction, or vascular death) following LAAC procedure, as well as procedural complications. Results A total of 241 patients (mean age [SD]= 76.8 [7.8] years; 37% women) from 4/6 sites were included in this preliminary analysis. 100 (41.5%) had a lobar ICH and 141 (58.5%) a non-lobar ICH. Procedural complications occurred in 9 (3.73%) patients. During a median follow up of 26.2 months (IQR, 12.1-55.3), the incidence rate (per 100 person-year) of recurrent ICH, ischemic stroke and serious vascular events were 3.15 (95% CI, 1.95-4.82), 2.46 (1.40-3.99) and 4.66 (3.14-6.65), respectively. Conclusions Our findings suggest that LAAC is safe in patients with ICH and AF. Further data on the risk of recurrent ICH, Ischemic stroke and serious vascular events stratified by ICH location and post-procedural treatments will be presented at the conference. These data may inform the design of future clinical trials. Conflict of interest Nicolas Raposo reports personal fees from Novartis outside the submitted work.

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Cite This Study

Raposo et al. (2026) conducted a cohort in Intracerebral hemorrhage and atrial fibrillation (n=241). Percutaneous left atrial appendage closure (LAAC) was evaluated on Serious vascular events (composite of non-fatal stroke, non-fatal myocardial infarction, or vascular death) (Incidence rate per 100 person-years, 95% CI 3.14-6.65). Left atrial appendage closure in patients with intracerebral hemorrhage and atrial fibrillation had a 3.73% procedural complication rate and 4.66 serious vascular events per 100 person-years.

synapsesocial.com/papers/69fd7e79bfa21ec5bbf06bbc https://doi.org/10.1093/esj/aakag023.403