Related Experiment Video
Updated: May 17, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Use of an active fixation lead and a subpectoral pacemaker pocket may not avoid Twiddler's syndrome
Floris E A Udink Ten Cate1, Roland Adelmann, Beate E Schmidt
1Department of Pediatric Cardiology, Heart Center Cologne, University Hospital of Cologne, Cologne, Germany.
Abstract:
Manipulation of a pacemaker with consequent malfunction of the device has been called Twiddler's syndrome. Use of active-fixation leads and subpectoral pacemaker pockets has been considered to help in avoiding this problem. We describe a child in whom twiddling was not prevented despite implantation of a lumenless atrial lead and insertion of the pacemaker generator in a subpectoral pocket.

