Twiddler's syndrome: Difference between revisions
Kurtucla05 (talk | contribs) (Created page with "==Background== *Implantable devices with attached wires traveling remotely are at risk for this complication. *Device moves within subcutaneous pocket acting like fishing rod...") |
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*Implantable devices with attached wires traveling remotely are at risk for this complication. | *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." | *Device moves within subcutaneous pocket acting like fishing rod pulling wires back to the "pole." | ||
*Wires dislodged from | *Wires dislodged from intended location in myocardium. | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 16:59, 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 placement of the leads
Management
- Cardiologist for device/lead placement
Disposition
- Admit to allow for device intervention as pacemaker does not function in Twiddler's Syndrome