Clinical Images  |   May 2017
Pacemaker Twiddler Syndrome
Author Notes
  • From the Department of Emergency Medicine at the Henry Ford Wyandotte Hospital in Michigan (Dr Zygowiec); the Department of Internal Medicine at Garden City Hospital in Michigan (Dr Pham); and the Department of Emergency Medicine at the Riverside Medical Center in Kankakee, Illinois (Dr Smithgall). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  • Disclaimer: The views expressed herein are those of the authors and do not reflect the official policy of the Department of the Air Force Reserve, the Department of Defense, or the US Government. 
  •  *Address correspondence to CPT Jonathan Zygowiec, DO, MPH, Department of Emergency Medicine, Henry Ford Wyandotte Hospital, 2333 Biddle Ave, Wyandotte, MI 48192-4668. E-mail: jzygowi2@hfhs.org
     
Article Information
Cardiovascular Disorders / Imaging / Clinical Images
Clinical Images   |   May 2017
Pacemaker Twiddler Syndrome
The Journal of the American Osteopathic Association, May 2017, Vol. 117, 339. doi:10.7556/jaoa.2017.066
The Journal of the American Osteopathic Association, May 2017, Vol. 117, 339. doi:10.7556/jaoa.2017.066
An 80-year-old woman presented to the emergency department with syncopal episodes and fatigue for several hours. The patient had a history of bradycardia-tachycardia syndrome after the placement of a pacemaker in 2003. The patient reported dizziness, nausea, and mild, nonexertional shortness of breath for several days. She denied intentionally manipulating her pacemaker. Plain film radiograph of her chest showed that the pulse generator header of her pacemaker had rotated, and the leads were coiled and retracted (image). Pacemaker twiddler syndrome was diagnosed. The patient was admitted to the hospital and underwent a surgical procedure to replace the leads. No complications occurred. 
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