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Inchworming: A Novel Motor Stereotypy in the BTBR T+ Itpr3tf/J Mouse Model of Autism

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The twiddler's plus syndrome--a case report.

Ashutosh Kumar¹, Biswakes Majumdar, Gautam Dutta

¹Institute of Postgraduate Education and Reseach, 244 A.J.C Bose Road, Kolkata 700 020 India. ashutoshvani@yahoo.co.in

Kardiologia Polska

|December 18, 2009

Summary

Twiddler's syndrome can cause severe pacemaker lead dislodgement and fracture. This case highlights an extreme presentation in a 43-year-old male, emphasizing the need for awareness.

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Area of Science:

Cardiology
Medical Devices
Patient Safety

Background:

Pacemaker lead integrity is crucial for device function.
Twiddler's syndrome, characterized by repetitive lead manipulation, can lead to complications.
Understanding the spectrum of Twiddler's syndrome is important for clinical management.

Observation:

A 43-year-old male presented with symptoms suggestive of pacemaker malfunction.
Physical examination revealed an unusual position of the pacemaker generator.
Imaging confirmed significant dislodgement and fracture of the pacemaker lead.

Findings:

The patient exhibited an extreme manifestation of Twiddler's syndrome.
Complete dislodgement and fracture of the pacemaker lead were identified.
This represents a rare but severe complication of lead manipulation.

Implications:

This case underscores the potential for severe mechanical complications associated with Twiddler's syndrome.
Clinicians should maintain a high index of suspicion for lead dislodgement in patients with pacemakers, especially those with behavioral factors.
Further research into preventative strategies and early detection of Twiddler's syndrome is warranted.