A Case of Subcutaneous Implantable Cardioverter-Defibrillator Twiddler's
Syndrome
Abstract
Twiddler’s syndrome is a rare complication where a pacemaker or
implantable cardioverter-defibrillator (ICD) is displaced with or
without patient manipulation of their device. There are reports on
transvenous devices but a paucity of data on subcutaneous devices. A
50-year-old male with hypertrophic cardiomyopathy and non-sustained
ventricular tachycardia underwent subcutaneous-ICD (S-ICD) implantation
for primary prevention. Remote device interrogation 4 weeks after device
placement reported a shock due to “ventricular fibrillation”. It also
showed abnormal lead impedance. Chest X-ray showed lead was dislodged
and coiled around the pulse generator. Patient underwent lead revision
and device replacement without further complications.