Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-06-09T05:59:31.409Z Has data issue: false hasContentIssue false

Twiddler’s syndrome with occult lead insulation damage in a child with epicardial pacemaker leads

Published online by Cambridge University Press:  19 May 2020

Peter Kramer
Affiliation:
Department of Congenital Heart Disease, Pediatric Cardiology, German Heart Centre Berlin, 13353Berlin, Germany
Felix Berger
Affiliation:
Department of Congenital Heart Disease, Pediatric Cardiology, German Heart Centre Berlin, 13353Berlin, Germany Department of Pediatric Cardiology, Charité – Universitätsmedizin Berlin, 13353Berlin, Germany German Centre for Cardiovascular Research (DZHK), 13347Berlin, Germany
Björn Peters*
Affiliation:
Department of Congenital Heart Disease, Pediatric Cardiology, German Heart Centre Berlin, 13353Berlin, Germany
*
Author for correspondence: B. Peters, MD, Department of Congenital Heart Disease, Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353Berlin, Germany. Tel: +49 30 4593 2800; Fax: +49 30 4593 2900. E-mail: peters@dhzb.de

Abstract

We present a rare case of incidentally diagnosed Twiddler’s syndrome in a child 7 years after implantation of a dual-chamber pacemaker system with epicardial leads. During revision, an insulation defect of the ventricular lead was evident, despite unremarkable prior pacemaker lead testing. The lead was repaired and a new generator was suture-fixated to prevent re-occurrence of generator manipulation.

Type
Brief Report
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Morales, JL, Nava, S, Marquez, MF, et al.Idiopathic lead migration: concept and variants of an uncommon cause of cardiac implantable electronic device dysfunction. JACC Clin Electrophysiol 2017; 3: 13211329.CrossRefGoogle ScholarPubMed
Fahraeus, T, Hoijer, CJ. Early pacemaker Twiddler syndrome. Europace 2003; 5: 279281.CrossRefGoogle ScholarPubMed
Hill, PE. Complications of permanent transvenous cardiac pacing: a 14-year review of all transvenous pacemakers inserted at one community hospital. Pacing Clin Electrophysiol 1987; 10: 564570.CrossRefGoogle ScholarPubMed
Abrams, S, Peart, I. Twiddler’s syndrome in children: an unusual cause of pacemaker failure. Br Heart J 1995; 73: 190192.CrossRefGoogle ScholarPubMed
Berul, CI, Hill, SL, Estes, NA 3rd. A teenager with pacemaker Twiddler syndrome. J Pediatr 1997; 131: 496497.Google ScholarPubMed
Ellis, AR, Reed, JH, Fairbrother, D. A tangled affair: pacemaker malfunction and syncope in a child due to Twiddler’s syndrome. Cardiol Young 2007; 17: 220222.CrossRefGoogle Scholar
Udink Ten Cate, FE, Adelmann, R, Schmidt, BE, Sreeram, N. Use of an active fixation lead and a subpectoral pacemaker pocket may not avoid Twiddler’s syndrome. Ann Pediatr Cardiol 2012; 5: 203204.CrossRefGoogle Scholar

Kramer et al. supplementary material

Kramer et al. supplementary material

Download Kramer et al. supplementary material(Video)
Video 19.9 MB