Twiddler's syndrome is a rare but important cause of lead dislodgement in patients with CRT-D devices.
Twiddler's syndrome warrants consideration in CRT-D lead dislodgement; this case extends sparse reports of longitudinal rotation but leaves prevention strategies open.
Twiddler's syndrome is a rare cause of pacemaker lead dislodgement. A 61-year-old female patient was implanted with a defibrillator capable of cardiac re-synchronization therapy (CRT-D); 10 months later, she presented with uneasiness and vibratory sensations in the chest. Fluoroscopy revealed rotation of the pulse generator along its longitudinal axis and dislodgement of all three leads. Diagnosis of Twiddler's syndrome was made.
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Bhatt et al. (2015) studied this question.
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