CTICasesTwiddler Syndrome
Imaging findings
Radiographs of a patient with an ICD show the atrial lead is retracted and not in the atrium, and the generator has rotated in its pocket compared to prior films.
Key takeaways
Twiddler syndrome occurs when a patient consciously or unconsciously manipulates their implanted device, causing the leads to coil and dislodge. This can lead to unintended nerve stimulation (e.g., phrenic nerve causing abdominal thumping).
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