CTICasesTwiddler Syndrome
Imaging findings
A patient who recently underwent pacemaker placement presented with involuntary diaphragm stimulation (jumping sensation). Imaging revealed a dislodged right atrial lead that had migrated due to rotation of the generator.
Key takeaways
Twiddler syndrome occurs when a pacemaker generator rotates in a capacious pocket, leading to lead dislodgement. It should be suspected in patients presenting with new diaphragmatic or chest wall symptoms post-implantation.
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