Twiddler's syndrome: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Pacemaker placed with poor function. | *Pacemaker placed with poor function. | ||
*Can present with syncope from lack of pacemaker function. | *Can present with syncope from lack of pacemaker function.<ref>Annals of Emergency Medicine, Volume 65, Frizell AW et al, A Peculiar Pacemaker Problem, Copyright Elsevier 2015.</ref> | ||
*Can present with symptoms related to stimulation of other structures (diaphragm, brachial plexus) as wires migrate from expected position. | *Can present with symptoms related to stimulation of other structures (diaphragm, brachial plexus) as wires migrate from expected position. | ||
Revision as of 17:13, 10 August 2015
Background
- Implantable devices with attached wires traveling remotely are at risk.
- Device moves within subcutaneous pocket pulling wires back to device with intentional or unintentional movements.
- Wires dislodged from intended location in myocardium.
Clinical Features
- Pacemaker placed with poor function.
- Can present with syncope from lack of pacemaker function.[1]
- Can present with symptoms related to stimulation of other structures (diaphragm, brachial plexus) as wires migrate from expected position.
Differential Diagnosis
- Lead separation
- Lead dislodgment
- Lead infection
Diagnosis
- CXR to evaluate the lead location
Management
- Cardiologist for device/lead placement
Disposition
- Admit for device revision
See Also
External Links
References
- ↑ Annals of Emergency Medicine, Volume 65, Frizell AW et al, A Peculiar Pacemaker Problem, Copyright Elsevier 2015.