1Department of Internal Medicine, Richmond University Medical Center, Staten Island, NY, USA
2Barnard College, New York City, NY, USA
3Department of Internal Medicine, Ascension St Agnes Hospital, Baltimore, USA
4Department of Electrophysiology, Richmond University Medical Center, Staten Island, NY, USA
American Journal of Cardiovascular Disease Research.
2025,
Vol. 10 No. 1, 15-17
DOI: 10.12691/ajcdr-10-1-3
Copyright © 2025 Science and Education PublishingCite this paper: Resha Reya Ganthan, Rayna Isber, Joud Fahed, Nidal Isber. Twiddler Syndrome without Twiddling: A Case of Lead Dislodgment and Inappropriate Shocks.
American Journal of Cardiovascular Disease Research. 2025; 10(1):15-17. doi: 10.12691/ajcdr-10-1-3.
Correspondence to: Resha Reya Ganthan, Department of Internal Medicine, Richmond University Medical Center, Staten Island, NY, USA. Email:
reshareya15@gmail.comAbstract
Twiddler syndrome is a rare complication of cardiac implantable electronic devices (CIEDs) typically caused by patient manipulation of the generator, leading to lead dislodgement. We present a unique case of a patient with a biventricular implantable cardioverter-defibrillator (ICD) who developed atrial and ventricular lead dislodgement without evidence of device manipulation. The patient experienced six consecutive inappropriate ICD shocks due to oversensing and double counting of atrial and ventricular signals by the right ventricular (RV) lead. This case highlights a variant of Twiddler syndrome occurring in the absence of twiddling, underscoring the importance of vigilance for device malfunction even without patient-induced factors.
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