CTICasesPacemaker Generator Migration
Imaging findings
Serial radiographs show a pacemaker generator that has shifted position and rotated on the lateral view. CT chest confirms that the pacemaker generator has migrated and lodged deep within the intercostal muscles of the chest wall, causing localized pain.
Key takeaways
Pacemaker or ICD generator migration (sometimes called Twiddler's syndrome or local displacement) can occur due to inadequate pocket fixation, allowing the device to track into the intercostal muscles or subcutaneous tissues and cause localized chest wall pain.
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