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

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.