Twiddler's syndrome: Difference between revisions
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[[File:Twiddler's_syndrome.jpg|Twiddler's syndrome| | {{SI}} | ||
{{Infobox medical condition | |||
| name = Twiddler's syndrome | |||
| image = [[File:Twiddler's_syndrome.jpg|250px]] | |||
| caption = X-ray showing lead displacement in Twiddler's syndrome | |||
| field = [[Cardiology]] | |||
| symptoms = [[Device malfunction]], [[lead displacement]] | |||
| complications = [[Device failure]], [[loss of therapy]], [[infection]] | |||
| onset = Typically after [[pacemaker]] or [[implantable cardioverter-defibrillator]] (ICD) implantation | |||
| duration = Chronic unless corrected | |||
| causes = Manipulation or "twiddling" of the device by the patient | |||
| risks = [[Elderly patients]], [[psychiatric disorders]], [[dementia]] | |||
| diagnosis = [[X-ray]], [[device interrogation]] | |||
| differential = [[Lead fracture]], [[lead dislodgement]], [[device malfunction]] | |||
| prevention = Patient education, secure device placement | |||
| treatment = Repositioning of the device, [[lead revision]] | |||
| prognosis = Good with appropriate intervention | |||
| frequency = Rare | |||
}} | |||
'''Twiddler's syndrome''' is a rare but serious complication associated with the use of implantable medical devices, such as [[pacemakers]] and [[implantable cardioverter-defibrillators]] (ICDs). This condition occurs when a patient manipulates or "twiddles" the device, leading to displacement or malfunction of the leads. | |||
==Presentation== | ==Presentation== | ||
Patients with Twiddler's syndrome may present with symptoms of device malfunction, such as [[syncope]], [[dizziness]], or [[palpitations]]. The physical manipulation of the device can cause the leads to dislodge from their intended position, resulting in ineffective pacing or defibrillation. | Patients with Twiddler's syndrome may present with symptoms of device malfunction, such as [[syncope]], [[dizziness]], or [[palpitations]]. The physical manipulation of the device can cause the leads to dislodge from their intended position, resulting in ineffective pacing or defibrillation. | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis of Twiddler's syndrome typically involves a combination of patient history, physical examination, and imaging studies. [[Chest X-ray]] or [[fluoroscopy]] can reveal the abnormal position of the leads. Additionally, interrogation of the device can show abnormal lead parameters or lack of appropriate device function. | Diagnosis of Twiddler's syndrome typically involves a combination of patient history, physical examination, and imaging studies. [[Chest X-ray]] or [[fluoroscopy]] can reveal the abnormal position of the leads. Additionally, interrogation of the device can show abnormal lead parameters or lack of appropriate device function. | ||
==Management== | ==Management== | ||
Management of Twiddler's syndrome involves educating the patient about the importance of not manipulating the device. Surgical intervention may be required to reposition the leads and secure the device more effectively. In some cases, a different device placement technique may be employed to prevent recurrence. | Management of Twiddler's syndrome involves educating the patient about the importance of not manipulating the device. Surgical intervention may be required to reposition the leads and secure the device more effectively. In some cases, a different device placement technique may be employed to prevent recurrence. | ||
==Prevention== | ==Prevention== | ||
Preventive measures include thorough patient education and the use of secure device implantation techniques. Ensuring that the device is anchored properly can reduce the risk of Twiddler's syndrome. | Preventive measures include thorough patient education and the use of secure device implantation techniques. Ensuring that the device is anchored properly can reduce the risk of Twiddler's syndrome. | ||
==See also== | |||
== | |||
* [[Pacemaker]] | * [[Pacemaker]] | ||
* [[Implantable cardioverter-defibrillator]] | * [[Implantable cardioverter-defibrillator]] | ||
| Line 20: | Line 34: | ||
* [[Palpitations]] | * [[Palpitations]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Medical conditions]] | [[Category:Medical conditions]] | ||
[[Category:Medical device complications]] | [[Category:Medical device complications]] | ||
{{Cardiology-stub}} | {{Cardiology-stub}} | ||
{{medicine-stub}} | {{medicine-stub}} | ||
Latest revision as of 19:13, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Twiddler's syndrome | |
|---|---|
| |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Device malfunction, lead displacement |
| Complications | Device failure, loss of therapy, infection |
| Onset | Typically after pacemaker or implantable cardioverter-defibrillator (ICD) implantation |
| Duration | Chronic unless corrected |
| Types | N/A |
| Causes | Manipulation or "twiddling" of the device by the patient |
| Risks | Elderly patients, psychiatric disorders, dementia |
| Diagnosis | X-ray, device interrogation |
| Differential diagnosis | Lead fracture, lead dislodgement, device malfunction |
| Prevention | Patient education, secure device placement |
| Treatment | Repositioning of the device, lead revision |
| Medication | N/A |
| Prognosis | Good with appropriate intervention |
| Frequency | Rare |
| Deaths | N/A |
Twiddler's syndrome is a rare but serious complication associated with the use of implantable medical devices, such as pacemakers and implantable cardioverter-defibrillators (ICDs). This condition occurs when a patient manipulates or "twiddles" the device, leading to displacement or malfunction of the leads.
Presentation[edit]
Patients with Twiddler's syndrome may present with symptoms of device malfunction, such as syncope, dizziness, or palpitations. The physical manipulation of the device can cause the leads to dislodge from their intended position, resulting in ineffective pacing or defibrillation.
Diagnosis[edit]
Diagnosis of Twiddler's syndrome typically involves a combination of patient history, physical examination, and imaging studies. Chest X-ray or fluoroscopy can reveal the abnormal position of the leads. Additionally, interrogation of the device can show abnormal lead parameters or lack of appropriate device function.
Management[edit]
Management of Twiddler's syndrome involves educating the patient about the importance of not manipulating the device. Surgical intervention may be required to reposition the leads and secure the device more effectively. In some cases, a different device placement technique may be employed to prevent recurrence.
Prevention[edit]
Preventive measures include thorough patient education and the use of secure device implantation techniques. Ensuring that the device is anchored properly can reduce the risk of Twiddler's syndrome.
See also[edit]
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