For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
14
views
13
references
 Top references
cited by
7
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      218
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Twiddler's Syndrome: Case Report and Literature Review

      case-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Twiddler's syndrome is a rare complication after pacemaker implantation usually caused by patient manipulation with generator. We describe a case of 70-year-old female patient with pacemaker who was admitted to the neurological clinic with syncope and suspicion for neurological disease. After neurological diagnostic tests that were negative and consultation with a cardiologist, Twiddler's syndrome was diagnosed.

          Related collections

          Most cited references13

          • Record: found
          • Abstract: not found
          • Article: not found

          The pacemaker-twiddler's syndrome: a new complication of implantable transvenous pacemakers.

          C Bayliss, D S Beanlands, R J Baird (2015)
          Article 0 comments Cited 42 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Early pacemaker twiddler syndrome.

            T. Fåhraeus, J Höijer (2003)
            Twiddler's syndrome is a well-known complication of pacemaker treatment. It was first described by Bayliss et al. when a patient manipulated and rotated the pulse generator in the pocket so many turns that it resulted in lead dislodgment, diaphragmatic stimulation and loss of capture. In this case report we present a patient who managed to rotate her dual chamber pulse generator so quickly after implantation that exit block occurred within 17 h. She had wound the two leads as far as their tips in a perfect formation around the pulse generator.
            Article 0 comments Cited 20 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              The pacemaker-twiddler’s syndrome: an infrequent cause of pacemaker failure

              Mohammad Salahuddin, Fathima Cader, Sahela Nasrin … (2016)
              Background The pacemaker-twiddler’s syndrome is an uncommon cause of pacemaker malfunction. It occurs due to unintentional or deliberate manipulation of the pacemaker pulse generator within its skin pocket by the patient. This causes coiling of the lead and its dislodgement, resulting in failure of ventricular pacing. More commonly reported among elderly females with impaired cognition, the phenomenon usually occurs in the first year following pacemaker implantation. Treatment involves repositioning of the dislodged leads and suture fixation of the lead and pulse generator within its pocket. Case presentation An 87 year old Bangladeshi lady who underwent a single chamber ventricular pacemaker (VVI mode: i.e. ventricle paced, ventricle sensed, inhibitory mode) implantation with the indication of complete heart block, and presented to us again 7 weeks later, with syncopal attacks. She admitted to repeatedly manipulating the pacemaker generator in her left pectoral region. Physical examination revealed a heart rate of 42 beats/minute, blood pressure 140/80 mmHg and bilateral crackles on lung auscultation. She had no cognitive deficit. An immediate electrocardiogram showed complete heart block with pacemaker spikes and failure to capture. Chest X-ray showed coiled and retracted right ventricular lead and rotated pulse generator. An emergent temporary pace maker was set at a rate of 60 beats per minute. Subsequently, she underwent successful lead repositioning with strong counselling to avoid further twiddling. Conclusion Twiddler’s syndrome should be considered as a cause of pacemaker failure in elderly patients presenting with bradyarrythmias following pacemaker implantation. Chest X-ray and electrocardiograms are simple and easily-available first line investigations for its diagnosis. Lead repositioning is required, however proper patient education and counselling against further manipulation is paramount to long-term management.
              Article 0 comments Cited 12 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Heart Views
                Journal ID (iso-abbrev): Heart Views
                Journal ID (publisher-id): HV
                Title: Heart Views : The Official Journal of the Gulf Heart Association
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 1995-705X
                ISSN (Electronic): 0976-5123
                Publication date (Print): Jan-Mar 2018
                Volume: 19
                Issue: 1
                Pages: 27-31
                Affiliations
                [1]Cardiosurgery Clinic, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
                Author notes
                Address for correspondence: Dr. Elnur Tahirovic, Cardiosurgery Clinic, University Clinical Center Sarajevo, Bolnicka 25, Sarajevo, Bosnia and Herzegovina. E-mail: elnur.tahirovic@ 123456gmail.com
                Article
                Publisher ID: HV-19-27
                DOI: 10.4103/HEARTVIEWS.HEARTVIEWS_89_17
                PMC ID: 5965012
                PubMed ID: 29876029
                SO-VID: 05bf4cd6-1f96-476d-9473-8e9a4238fc6c
                Copyright © Copyright: © 2018 Heart Views
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: pacemaker malfunction,syncope,twiddler's syndrome
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: pacemaker malfunction, syncope, twiddler's syndrome

                Comments

                Comment on this article

                scite_

                Similar content218

                See all similar

                Cited by7

                See all cited by

                Most referenced authors68

                See all reference authors