title: Pacemaker-twiddler's syndrome: a rare cause of lead displacement and pacemaker malfunction.
abstract: Pacemaker-twiddler's syndrome is characterized by spontaneous, subconscious, inadvertent, or deliberate rotation of the pulse generator by the patient resulting in lead dislodgement and pacemaker malfunction. We present a case of pacemaker-twiddler's syndrome that involved an atrioventricular sequential pacemaker. It resulted in failure of atrial lead capture and phrenic nerve stimulation but without loss of ventricular lead capture. A search of the literature revealed only ten previous cases reported; none were in the emergency medicine literature, and none involved an atrioventricular sequential pacemaker.
authors.affiliation: Department of Emergency Medicine, Wright State University School of Medicine, Dayton, Ohio.
authors.forename: G M
authors.initials: GM
authors.lastname: Newland
authors.forename: T G
authors.initials: TG
authors.lastname: Janz
mesh_terms: D004244:Dizziness / Q000209:etiology*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D013577:Syndrome