Left Atrial Appendage Closure Shows Safety and Reduced Events in ICH

Jun 01, 2025

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The following is a summary of “Ischemic outcomes after left atrial appendage closure following intracerebral hemorrhage: a retrospective inverse probability weighting analysis from the HANSE-LAAC registry,” published in the May 2025 issue of Clinical Research in Cardiology by Jurczyk et al.

Researchers conducted a retrospective study to examine the clinical benefits of left atrial appendage closure (LAAC) in individuals with intracerebral hemorrhage (ICH) and atrial fibrillation (AF).

They analyzed data from the single-center HANSE–LAAC registry, which included consecutively treated individuals from 2014 to 2022. The index procedures and standardized follow-ups at 3 and 12 months were reviewed to assess safety and efficacy. Mortality, major adverse cardiovascular events (MACE), and bleeding events were compared between individuals with and without ICH. Cox proportional hazard models and inverse probability weighting were applied to adjust for potential confounders.

The results showed that 401 individuals underwent percutaneous LAAC, including 15.2% (n = 61) with ICH and 84.8% (n = 340) without ICH. The composite outcome of death, MACE, and bleeding was significantly lower in the ICH group (HR 0.35; CI 0.05–4.62; P= 0.0044). This was primarily due to reduced bleeding events (HR 0.27; CI 0.06–1.15; P= 0.04). Re-hospitalization rates were also significantly lower (HR 0.36; CI 0.20–0.64; P< 0.0001). After adjusting for confounders and applying inverse probability weighting, no significant differences were observed in mortality (HR 0.53; CI 0.15–1.92; P= 0.33), stroke (HR 0.32; CI 0.03–3.13; P= 0.33), bleeding (HR 0.26; CI 0.05–1.29; P= 0.02), or MACE (HR 0.29; CI 0.04–2.36; P= 0.002).

Investigators concluded that LAAC in patients with ICH was safe and associated with fewer MACE, bleeding events, and re-hospitalizations, although randomized controlled trials were necessary to confirm these initial positive findings.

Source: link.springer.com/article/10.1007/s00392-025-02668-7