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Defibrillator twiddler's syndrome causing device failure in a subpectoral transvenous system
G H Crossley1, D D Gayle, J R Bailey
1Department of Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1045, USA.
Pacing and Clinical Electrophysiology : PACE
|March 1, 1996
Summary
Twiddler's syndrome, a complication of cardiac devices, can occur even with subpectoral implantations. This placement may increase the risk of lead retraction and inappropriate shocks from implantable defibrillators.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Twiddler's syndrome is a known complication associated with cardiac pacing devices.
- Recent reports indicate its occurrence with implantable defibrillator systems, including abdominal placements.
Observation:
- A case of Twiddler's syndrome is presented in a patient with a transvenous defibrillator system.
- The pulse generator was implanted in the subpectoral plane.
Findings:
- The patient developed Twiddler's syndrome, leading to significant retraction of both atrial and ventricular leads.
- This lead retraction resulted in inappropriate shocks due to misinterpretation of cardiac electrical signals.
Implications:
- Subpectoral placement of defibrillator pulse generators, while deeper, does not eliminate the risk of Twiddler's syndrome.
- This anatomical positioning might even contribute to the development of Twiddler's syndrome, warranting further investigation.