title: Early pacemaker twiddler syndrome.
abstract: Twiddler's syndrome is a well-known complication of pacemaker treatment. It was first described by Bayliss et al. when a patient manipulated and rotated the pulse generator in the pocket so many turns that it resulted in lead dislodgment, diaphragmatic stimulation and loss of capture. In this case report we present a patient who managed to rotate her dual chamber pulse generator so quickly after implantation that exit block occurred within 17 h. She had wound the two leads as far as their tips in a perfect formation around the pulse generator.
authors.affiliation: Pacemaker Department, Heart- and Lung Division, University Hospital of Lund, Lund, Sweden. thomas.fahraeus@skane.se
authors.forename: T
authors.initials: T
authors.lastname: Fahraeus
authors.forename: C J
authors.initials: CJ
authors.lastname: Höijer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001146:Arrhythmia, Sinus / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001919:Bradycardia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D004567:Electrodes, Implanted / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006327:Heart Block / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011859:Radiography; D013577:Syndrome