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June 27, 2026EP EuropaceOpen Access

LAAO was independently associated with a significant risk reduction for the primary composite outcome compared to usual care (HR 0.233; 95% CI 0.087–0.626; p=0.004).

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Why the study?

Does LAAO reduce the composite of stroke recurrence, major bleeding, or all-cause mortality in AF patients with haemorrhagic transformation compared to usual care?

Population

81 patients with atrial fibrillation and haemorrhagic transformation, without other indications for…

Comparison

Left atrial appendage occlusion (LAAO) vs Usual care (conservative treatment)

Design

Cohort

Follow-up

22 months

Authors

RPR Bril ParozMGM GoldsteinNAN Agay

Discussion

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Overview

LAAO linked to lower composite risk should not yet change practice; leaves open need for RCTs versus anticoagulation in post-stroke AF.

Key Points

  • This research aims to assess the outcomes of atrial fibrillation patients with haemorrhagic transformation treated with left atrial appendage occlusion.
  • Retrospective cohort study at a tertiary medical center (January 2018 - December 2024)
  • Inclusion of AF patients with HT treated with LAAO compared to usual care
  • Primary endpoint was composite of stroke recurrence, major bleeding, or all-cause mortality.
  • In the LAAO group, freedom from primary outcomes was 75% at 22 months compared to 35% in controls (log-rank p = 0.0026)
  • LAAO demonstrated a hazard ratio (HR) of 0.233 for adverse outcomes (95% CI, 0.087–0.626; p = 0.004)
  • Patients aged >80 years showed a twofold increase in risk (HR = 2.010; 95% CI, 1.024–3.944; p = 0.0424).

Structured PICO

Does LAAO reduce the composite of stroke recurrence, major bleeding, or all-cause mortality in AF patients with haemorrhagic transformation compared to usual care?

P
Population
81 patients with atrial fibrillation (AF) and haemorrhagic transformation (HT), without other indications for anticoagulation. 20 treated with LAAO [40% female, mean age 76 (71–79)] and 61 controls [51% female, mean age 79 (72–85)].
I
Intervention
Left atrial appendage occlusion (LAAO)
C
Comparator
Usual care (conservative treatment)
O
Outcome
Composite of stroke recurrence, major bleeding, or all-cause mortalitycomposite

In AF patients with haemorrhagic transformation, LAAO was associated with a 76% reduction in the composite of stroke recurrence, major bleeding, or mortality compared to conservative treatment.

Cite This Study

Paroz et al. (2026) studied this question.

synapsesocial.com/papers/6a3f97a5125782b61d8658a8https://doi.org/10.1093/europace/euag105.383
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