CTICasesTwiddler syndrome
Imaging findings
Chest radiograph shows a biventricular pacemaker generator rotated about its short axis, resulting in retraction of the left ventricular pacing lead out of the coronary sinus and into the right atrium.
Key takeaways
Twiddler syndrome can affect biventricular pacemakers, where short-axis rotation of the generator coils and retracts the coronary sinus lead, resulting in loss of left ventricular pacing. In females with pendulous breasts, gravitational pull can also contribute to lead migration.
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