CTICasesFlipped Pacemaker Generator (Twiddler Syndrome Variant)
Imaging findings
Serial chest radiographs in a patient with a recently implanted pacemaker demonstrate migration and 180-degree rotation of the generator along the vertical (cranial-caudal) axis, resulting in a mirror-image appearance of the generator. The lead wires show a loop but remain securely positioned in the heart chambers.
Key takeaways
Pacemaker twiddler's syndrome is a malfunction characterized by the patient's conscious or unconscious manipulation of the generator, leading to rotation and coiling of the lead wires around the device, often causing lead displacement. A variant involves the generator flipping 180 degrees along the vertical axis within a spacious pocket, which may not cause lead dislodgement but can interfere with device programming or function.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Aortic Valve ThrombusVascular
- Thoracotomy-Induced Keloid FormationIatrogenic
- Lupus-Associated Pulmonary FibrosisAutoimmune
- Tracheobronchial Stent MigrationIatrogenic
- Malignant Pericardial EffusionNeoplastic
- Enterococcal EndocarditisInfection
- Sternal Wire DehiscenceIatrogenic
- LymphangioleiomyomatosisNeoplastic
See all cases from January 30, 2018 →