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.
Keywords: Twiddler; complication; defibrillation - ICD; sensing.
© 2015 Wiley Periodicals, Inc.