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Twiddler's syndrome: a new twist
Pacing and Clinical Electrophysiology : PACE
|November 1, 1984
Summary
Twiddler's syndrome, previously seen with pacemakers, can also affect patients with internal automatic cardioverter-defibrillators. Generator rotation can lead to lead dislodgment and loss of device function in this new patient group.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Twiddler's syndrome is a known complication of permanent pacemaker implantation for bradyarrhythmias.
- It involves dislodgment of pacemaker leads due to twisting of the pulse generator within its subcutaneous pocket.
- This twisting leads to lead retraction and loss of pacing function.
Observation:
- This report details the first observed case of Twiddler's syndrome in a patient with an internal automatic cardioverter-defibrillator (ICD).
- The patient experienced lead dislodgment specifically due to pulse generator rotation.
- This highlights a novel presentation of the syndrome.
Findings:
- Internal automatic cardioverter-defibrillator (ICD) pulse generator rotation can cause lead dislodgment.
- This complication results in loss of defibrillation and pacing capabilities.
- The findings expand the understanding of Twiddler's syndrome beyond traditional pacemakers.
Implications:
- This case identifies a new subset of patients at risk for Twiddler's syndrome.
- Clinicians should be aware of this potential complication in ICD patients.
- Further investigation may be warranted to understand the specific risks and preventive measures for ICDs.