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  • Title: Twiddling with an implantable cardioverter-defibrillator.
    Author: McCann CJ, Beelen R, Geelen P.
    Journal: Acta Cardiol; 2009 Oct; 64(5):695. PubMed ID: 20058522.
    Abstract:
    A 64-year-old woman underwent implantation of a single-chamber implantable cardioverter-defibrillator. The active fixation lead was positioned in the right ventricular apex and the generator in a left pre-pectoral pocket. Device interrogation 4weeks after implantation revealed inappropriate sensing and failure of pacing. A chest X-ray showed the entire lead coiled behind the device. The patient admitted manipulating the device and a diagnosis of Twiddler's syndrome was made. After repositioning the lead, the generator was re-located in the sub-pectoral position to help prevent recurrence by reducing the ability to externally manipulate the device.
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