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Document Details : Title: Twiddling with an implantable cardioverter-defibrillator Author(s): C.J. McCann , R. Beelen , P. Geelen Journal: Acta Cardiologica Volume: 64 Issue: 5 Date: 2009 Pages: 695-695 DOI: 10.2143/AC.64.5.2042706 Abstract : A 64-year-old woman underwent implantation of a single-chamber implantable cardioverter-defibrillator. The active fixation lead was positioned in the right ventricular apex and the generator in a left pre-pectoral pocket. Device interrogation 4 weeks after implantation revealed inappropriate sensing and failure of pacing. A chest X-ray showed the entire lead coiled behind the device. The patient admitted manipulating the device and a diagnosis of Twiddler’s syndrome was made. After repositioning the lead, the generator was re-located in the sub-pectoral position to help prevent recurrence by reducing the ability to externally manipulate the device. |