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The Annals of Thoracic Surgery, Vol 58, 247-249, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Defibrillator twiddler's syndrome

LA Robinson and JR Windle
Department of Surgery, University of Nebraska Medical Center, Omaha 68198-2315.

Long-term complications of internal cardioverter defibrillators have generally involved inappropriate shocks or hardware malfunctions. The present case documents a new problem of internal cardioverter defibrillator lead disruption resulting from patient-induced rotation of the generator in its pocket, similar to the previously reported pacemaker twiddler's syndrome. However, unlike the usual early symptoms of pacemaker nonfunction, the first symptomatic manifestation of the defibrillator twiddler's syndrome may be an inappropriate internal cardioverter defibrillator discharge or more importantly, unrescued sudden death. Careful attention to patient complaints about the internal cardioverter defibrillator generator and being alert to subtle lead changes on chest radiographs may allow the clinician to recognize this syndrome before a major, possibly fatal event.

This article has been cited by other articles:

				C. Mewis, V. Kuhlkamp, V. Dornberger, K. Kalighi, and L. Seipel LEAD FAILURE CAUSED BY TWIDDLER'S SYNDROME IN SUBPECTORALLY IMPLANTED UNIPOLAR SINGLE-LEAD CARDIOVERTER-DEFIBRILLATORS J. Thorac. Cardiovasc. Surg., December 1, 1997; 114(6): 1121 - 1122. [Full Text]

				S. Furman, L. A. Robinson, and J. R. Windle Defibrillator twiddler's syndrome. Ann. Thorac. Surg., February 1, 1995; 59(2): 544 - 546. [Full Text]