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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
PubMed

Insights

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.

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.

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