CTICasesFlipped Pacemaker Generator (Pre-Twiddler Syndrome)
Imaging findings
Serial chest radiographs three months apart demonstrate a 180-degree rotation/flip of the pacemaker generator along the vertical/z-axis inside its subcutaneous pocket, leading to wrapping of the pacing leads around the generator.
Key takeaways
Pacemaker or ICD generator rotation within the subcutaneous pocket (flipped generator) can occur in patients with large pockets or mobile subcutaneous tissue. This is a precursor to Twiddler's syndrome. Generator rotation wraps the leads around the device, risking lead tension, dislodgement, or malfunction.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- COVID-19 Myocarditis with Left Ventricular ThrombusInfection
- Pneumocystis jirovecii PneumoniaInfection
- Legionella pneumophila PneumoniaInfection
- Post-ARDS Tracheal Buckling and Scarring from H1N1 InfluenzaInfection
- Melanoma Spine Metastasis (Winking Owl Sign)Neoplastic
- Iatrogenic Subclavian Arterial Line PlacementIatrogenic
- Klebsiella and Aspergillus Co-infection in Cardiac TransplantInfection
- Iatrogenic Retrograde Brachiocephalic DissectionIatrogenic
See all cases from April 2, 2020 →