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Right arrow Electrophysiology - arrhythmias

J Thorac Cardiovasc Surg 2005;129:231-232
© 2005 The American Association for Thoracic Surgery

Brief Communications

Lead system causing twiddler's syndrome in patients with an implantable cardioverter-defibrillator

F. Bracke, MDa,*, B. van Gelder, PhDa, B. Dijkman, MD, PhDb, A. Meijer, MD, PhDa

a Department of Cardiology, Catharina Hospital Eindhoven
b Academic Hospital Maastricht, The Netherlands

Received for publication November 17, 2001; accepted for publication December 10, 2001.

* Address for reprints: F. Bracke, MD, Department of Cardiology, Catharina Hospital, 2 Michelangelolaan, PO Box 1350, 5602 ZA Eindhoven, The Netherlands (E-mail: f.bracke@skynet.be).

The first 20% of the full text of this article appears below.

Three male patients with an implantable cardioverter-defibrillator (ICD) were referred for lead extraction because of twiddler's syndrome associated with lead malfunction detected during routine follow-up (Table 1). The ICDs were implanted in the left subpectoral region in a submuscular pocket. On chest radiograph, the position of the generator was the same as at implant in all 3 patients.


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  		TABLE 1. Patient and lead characteristics
 
All patients were satisfied with the device and denied manipulation of the generator or discomfort at the implant site. All had a history of recent strenuous physical exercise. None of the patients was obese or reported important weight loss since the time of implant.

We could not rotate the generator within the generator pocket in any of the patients, even during surgery, because the pocket fitted snugly in all. The leads were twisted tightly outside the generator pocket, and atrial . . . [Full Text of this Article]




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J. Thorac. Cardiovasc. Surg., February 1, 2010; 139(2): 499 - 501.
[Full Text] [PDF]


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