Sinus nodal dysfunction is common in the elderly and frequently requires a permanent cardiac pacemaker. Current pacemakers are extremely reliable but require ongoing monitoring to detect battery depletion and component or lead failure. This report describes a patient's manipulation of the pacemaker generator and proximal leads within the subcutaneous pocket with lead fracture and device malfunction. Diagnosis by chest X-ray and surgical revision are portrayed. Awareness of Twiddler's syndrome remains the key to its diagnosis.
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Article Synopsis
- Twiddler's syndrome is a rare condition associated with cardiac pacemakers, characterized by the twisting and retraction of the device lead within the implantation site.
- A 54-year-old woman was admitted to the emergency department due to chest pain and involuntary muscle contractions in her left side.
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Twiddler syndrome is a rare entity in which patient manipulation causes lead dislocation with lead retraction. Reel syndrome, on the other hand, is observed after external manipulation, intentional or unintentional, in which the leads move along their transverse axis and is considered a variant of Twiddler syndrome. We present the clinical case of a 91-year-old female who, after pacemaker implantation, presented with dizziness and chest discomfort following constant manipulation of the pacemaker, resulting in complete retraction of the lead tip into the pouch, which is unusual in the literature to date.
View Article and Find Full Text PDFOld problem surfaces with new technology: Twiddler's syndrome in Barostim NEO.
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Introduction: Cardiac implantable electronic device (CIED) complications present significant challenges in clinical practice, especially in elderly patients with multiple comorbidities. Common adverse events include infection, lead malfunction, and device migration. Twiddler's Syndrome, a rare but serious CIED complication characterised by patient manipulation causing lead displacement and device malfunction, is often underreported.
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