title: Twisting until it breaks: a rare cause of ICD lead failure.
abstract: We describe a rare case of Twiddler's syndrome that resulted in a complex ICD lead fracture involving both the insulation and the conductor. The conductor fracture resulted in noise artefact that was interpreted by the device as ventricular fibrillation, but the patient had not received any shocks because the "episodes" were non-sustained. The patient did not have traditional risk factors for Twiddler's syndrome.
authors.affiliation: Division of Cardiovascular Medicine-EP Section, SUNY Downstate, Brooklyn, NY 11203, USA. abudzikowski@downstate.edu
authors.forename: Adam S
authors.initials: AS
authors.lastname: Budzikowski
authors.forename: Eric
authors.initials: E
authors.lastname: Uyguanco
authors.forename: Moshe Y
authors.initials: MY
authors.lastname: Gunsburg
authors.forename: John
authors.initials: J
authors.lastname: Kassotis
mesh_terms: D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal / Q000379:methods; D004562:Electrocardiography; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D012086:Reoperation; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery