CTICases180-Degree Flip of a Defibrillator along the Long Axis
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Imaging findings
Serial chest radiographs demonstrate a defibrillator generator that has rotated 180 degrees along its long axis within the subcutaneous pocket. On the baseline radiograph, the lettering on the generator reads normally, whereas the subsequent radiograph shows the lettering as a mirror image, indicating a complete flip of the device. The leads remain intact without evidence of coiling, tension, or dislodgement.
Key takeaways
Unlike classic Twiddler's syndrome, which involves short-axis rotation and lead coiling, simple flipping of a device along its long axis can occur within a capacious subcutaneous pocket. If the device is interrogated and found to be functioning normally with adequate capture and lead integrity, surgical revision may not be necessary.
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