Presentation
Atypical palpitations.
Patient Data
Age: 60 years
Gender: Female
From the case:
Retracted pacemaker lead (Twiddler syndrome)
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/84054/annotated_viewer_json?iframe=true\u0026lang=us"}
The single lead of the left-sided cardiac device is retracted, with the tip projected in the midline likely within the left brachiocephalic vein. Redundant lead is coiled at the superior margin of the generator.
Cardiomegaly with signs of left atrial enlargement. Left lower lobe atelectasis.
Case Discussion
Twiddler syndrome is due to patient (purposeful or inadvertent) manipulation of the pacemaker device, causing retraction of the lead and dysfunction. This pacemaker had to be revised.