title: Use of an active fixation lead and a subpectoral pacemaker pocket may not avoid Twiddler's syndrome.
abstract: Manipulation of a pacemaker with consequent malfunction of the device has been called Twiddler's syndrome. Use of active-fixation leads and subpectoral pacemaker pockets has been considered to help in avoiding this problem. We describe a child in whom twiddling was not prevented despite implantation of a lumenless atrial lead and insertion of the pacemaker generator in a subpectoral pocket.
authors.affiliation: Department of Pediatric Cardiology, Heart Center Cologne, University Hospital of Cologne, Cologne, Germany.
authors.forename: Floris E A
authors.initials: FE
authors.lastname: Udink Ten Cate
authors.forename: Roland
authors.initials: R
authors.lastname: Adelmann
authors.forename: Beate E
authors.initials: BE
authors.lastname: Schmidt
authors.forename: Narayanswami
authors.initials: N
authors.lastname: Sreeram
keywords: Active fixation; Twiddler's syndrome; children; pacemaker; pacemaker failure