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Reverse Twiddler's syndrome
1Stony Brook Arrhythmia and Sudden Death Prevention Center, Cardiology Division, Department of Medicine, Stony Brook University, Stony Brook, NY 11794-8167, USA. svlay@notes.cc.sunysb.edu
Pacing and Clinical Electrophysiology : PACE
|January 15, 2009
Summary
Twiddler's syndrome involves pacemaker or defibrillator lead withdrawal due to arm motion. Reverse Twiddler's syndrome is the opposite lead advancement caused by similar repetitive movements.
Area of Science:
- Cardiology
- Medical Devices
- Patient Safety
Background:
- Pacemaker and defibrillator leads are crucial for cardiac rhythm management.
- Lead dislodgement can compromise device efficacy and patient health.
- Twiddler's syndrome describes lead withdrawal from repetitive arm movements.
Observation:
- A novel phenomenon, Reverse Twiddler's syndrome, has been observed.
- This involves the advancement of pacing or defibrillator leads into the heart.
- The mechanism is similar repetitive arm motion, but in the opposite direction.
Findings:
- Reverse Twiddler's syndrome represents lead advancement, contrasting with classical lead withdrawal.
- Repetitive manipulation of the pulse generator site is implicated in both syndromes.
- Understanding these lead migration patterns is vital for clinical practice.
Implications:
- Awareness of Reverse Twiddler's syndrome is essential for clinicians managing patients with cardiac implantable electronic devices.
- Patient education on appropriate device site care may help prevent lead migration.
- Further research is needed to fully elucidate the pathophysiology and long-term consequences of Reverse Twiddler's syndrome.
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