Twiddler's Syndrome: a Rare Complication of Pacemakers

Twiddler’s syndrome is a rare severe entity first described in 1968 related to transvenous pacemaker placement, involving the pulse generator in a subcutaneous pocket, and the coiling, displacement, or fracture of the leads causing stimulation failure and symptoms recurrence needing immediate revision. Major risk factors for the loss of pacemaker function include bad generator fixation, manipulation, psychiatric disorder, obesity, advanced age, and an oversized pocket. The objective is to emphasize the recent case studies published in this Journal.<br />