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Twiddler's Syndrome.

Jason A Lesnick1, Benjamin L Cooper1, Pratik B Doshi1

  • 1McGovern Medical School at the University of Texas Health Science Center in Houston (UTHealth), Department of Emergency Medicine, Houston, Texas.

Clinical Practice and Cases in Emergency Medicine
|August 13, 2019
PubMed
Summary
This summary is machine-generated.

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Twiddler's syndrome is a rare malfunction of pacemakers or AICDs caused by lead coiling in the skin pocket. Diagnosis via chest X-ray confirms lead displacement, necessitating surgical intervention.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Twiddler's syndrome is a rare cause of pacemaker and AICD malfunction.
  • It results from the device leads coiling within the subcutaneous pocket.
  • This coiling leads to lead displacement and device failure.

Purpose of the Study:

  • To describe a case of Twiddler's syndrome diagnosed via chest radiography.
  • To highlight the imaging findings characteristic of this condition.

Main Methods:

  • A 54-year-old male presented with chest pain post-AICD implantation.
  • A chest radiograph (CXR) was performed to evaluate the device and leads.
  • Radiographic findings were analyzed for signs of lead displacement.

Main Results:

Related Experiment Videos

  • The CXR revealed AICD leads coiled around the device.
  • Leads were absent from their expected ventricular position.
  • These findings were consistent with Twiddler's syndrome.

Conclusions:

  • Twiddler's syndrome can be diagnosed using chest radiography.
  • Patients diagnosed with Twiddler's syndrome require prompt operative intervention.