title: [Twiddler's syndrome in a left pectoral implanted defibrillator].
abstract: Twiddler's syndrome describes a rare complication following implantation of a pacemaker/defibrillator and is characterized by spontaneous, repeated rotation of the generator in the subpectoral pocket. We describe the case of a 78-year-old man who presented with an exit block 7 months after defibrillator implantation. As cause, a 15-fold rotation of the defibrillator's generator around its own axis could be verified, which entailed dislocation of the defibrillator's electrode. Safe fixation of the electrode and generator in the subpectoral pocket is of paramount importance, particularly in patients with loose subcutaneous fatty tissue, to prevent this rare complication.
authors: Chirurgische Klinik, St. Josef Hospital, Klinikum der Ruhruniversität Bochum, Gudrunstrasse 56, 44791, Bochum, Germany. sirileyendecker@gmx.de
authors: S S
authors: SS
authors: Leyendecker
authors: F
authors: F
authors: Reuter
authors: C
authors: C
authors: Steffens
authors: W
authors: W
authors: Uhl
authors: U
authors: U
authors: Mittelkötter
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004868:Equipment Failure; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010369:Pectoralis Muscles; D013902:Radiography, Thoracic; D012086:Reoperation; D013577:Syndrome; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging / Q000628:therapy; D013997:Time Factors