CTICasesTwiddler syndrome
Imaging findings
Chest radiograph shows a cardiac pacemaker generator rotated in its pocket, with the pacing lead completely withdrawn from the heart and coiled around the generator shell.
Key takeaways
Twiddler syndrome can lead to complete retraction of pacing leads out of the heart and into the pocket, causing loss of capture. Device pocket revision is required to secure the generator and prevent recurrent rotation.
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