Twiddler's syndrome: Difference between revisions
Kurtucla05 (talk | contribs) |
Kurtucla05 (talk | contribs) No edit summary |
||
Line 15: | Line 15: | ||
==Diagnosis== | ==Diagnosis== | ||
*CXR to evaluate the lead location | *CXR to evaluate the lead location[[File:Twiddler Syndrome.png|thumb|Twiddler Syndrome after large pocket and pacemaker wires spinning on themselves]] | ||
==Management== | ==Management== |
Revision as of 17:09, 10 August 2015
Background
- Implantable devices with attached wires traveling remotely are at risk for this complication.
- Device moves within subcutaneous pocket acting like fishing rod pulling wires back to the "pole."
- Wires dislodged from intended location in myocardium.
Clinical Features
- Pacemaker placed with poor function.
- Can present with syncope from lack of pacemaker function.
- 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 to allow for device intervention as pacemaker does not function in Twiddler's Syndrome