title: Subcutaneous Implantable Cardioverter Defibrillator Lead Failure due to Twiddler Syndrome.
abstract: We present a case of Twiddler syndrome in a patient with a subcutaneous implantable cardioverter defibrillator (S-ICD). The patient presented herself to the outpatient clinic with pain in the left chest. Chest x-ray confirmed Twiddler syndrome and ICD read-out revealed lead failure resulting in absent heart rhythm sensing in one vector. The lead and pulse generator were extracted and a new S-ICD system was reimplanted submuscular underneath the serratus anterior muscle to prevent reoccurrence. Lead investigation revealed an insulation defect caused by excessive mechanical stress.
authors: Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors: Kirsten M
authors: KM
authors: Kooiman
authors: Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors: Tom F
authors: TF
authors: Brouwer
authors: Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors: Vokko P
authors: VP
authors: Van Halm
authors: Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors: Reinoud E
authors: RE
authors: Knops
mesh_terms: D000328:Adult; D017147:Defibrillators, Implantable / Q000009:adverse effects; D020878:Device Removal; D005260:Female; D006801:Humans; D011475:Prosthesis Failure; D019919:Prosthesis Implantation; D013577:Syndrome
keywords: Twiddler; complication; defibrillation - ICD; sensing