Key result
Surgical removal of the Watchman device led to a significant resolution of persistent, idiopathic chest pain in a patient with atrial fibrillation.
Why the study?
Chest pain after left atrial appendage closure with the Watchman device is rare and typically caused by complications, but idiopathic cases present management challenges.
Does surgical removal of the Watchman device improve persistent idiopathic chest pain in patients following left atrial appendage closure?
Case Report (n=1)
Does surgical removal of the Watchman device improve persistent idiopathic chest pain in patients following left atrial appendage closure?
Surgical removal of a left atrial appendage closure device may be a necessary and effective treatment for persistent, idiopathic chest pain when conservative management fails.
Answers are grounded in this paper and cite their sources.
Unexplained post-Watchman chest pain warrants exclusion of complications; this case leaves open idiopathic etiology and requires prospective data.
Chest pain following left atrial appendage closure (LAAC) with the Watchman device is rare but can occur due to complications such as pericarditis or myocardial infarction. We present the case of a 59-year-old male with atrial fibrillation who developed sharp, left-sided chest pain exacerbated by inspiration after undergoing Watchman device placement. Despite extensive diagnostic evaluations, including electrocardiograms (ECGs), echocardiograms, and cardiac catheterization, the exact cause of the pain remained unclear, with no signs of acute coronary syndrome or pericardial effusion. The patient's symptoms persisted despite treatment with colchicine and anti-inflammatory agents including steroids. Due to the severe and persistent nature of the pain, the patient opted for surgical removal of the Watchman device. This procedure led to a significant resolution of his symptoms. This case underscores the need to consider device removal for persistent, idiopathic chest pain after LAA occlusion, especially when other causes are excluded and conservative management fails.
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Pervaiz et al. (2025) conducted a case report in Atrial fibrillation with idiopathic chest pain post-LAAC (n=1). Surgical removal of the Watchman device was evaluated on Resolution of symptoms. Surgical removal of the Watchman device led to a significant resolution of persistent, idiopathic chest pain in a patient with atrial fibrillation.
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