Subcutaneous Implantable Cardioverter Defibrillator Lead Failure due to Twiddler Syndrome

We present a case of Twiddler syndrome in a patient with a subcutaneous implantable cardioverter defibrillator (S‐ICD). The patient presented herself to the outpatient clinic with pain in the left chest. Chest x‐ray confirmed Twiddler syndrome and ICD read‐out revealed lead failure resulting in abse...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 2015-11, Vol.38 (11), p.1369-1371
Main Authors: KOOIMAN, KIRSTEN M., BROUWER, TOM F., HALM, VOKKO P. VAN, KNOPS, REINOUD E.
Format: Article
Language:English
Subjects:
Adult
complication
defibrillation - ICD
Defibrillators, Implantable - adverse effects
Device Removal
Female
Humans
Prosthesis Failure
Prosthesis Implantation
sensing
Syndrome
Twiddler
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Summary:We present a case of Twiddler syndrome in a patient with a subcutaneous implantable cardioverter defibrillator (S‐ICD). The patient presented herself to the outpatient clinic with pain in the left chest. Chest x‐ray confirmed Twiddler syndrome and ICD read‐out revealed lead failure resulting in absent heart rhythm sensing in one vector. The lead and pulse generator were extracted and a new S‐ICD system was reimplanted submuscular underneath the serratus anterior muscle to prevent reoccurrence. Lead investigation revealed an insulation defect caused by excessive mechanical stress.
ISSN:0147-8389
1540-8159
DOI:10.1111/pace.12741