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Case Reports
. 2021 Sep 30;62(5):1156-1159.
doi: 10.1536/ihj.21-019. Epub 2021 Sep 17.

Double Twist

Wei-Chieh Lee  1   2 , Yung-Lung Chen  2
Affiliations
Free article
Case Reports

Double Twist

Wei-Chieh Lee et al. Int Heart J. .
Free article

Abstract

A rare complication about "Twiddler syndrome" is reported, and an interesting image about "double twist" is presented. A 78-year-old woman received a single-chamber implantable cardioverter defibrillator (ICD) for secondary prevention of ventricular arrhythmia. After she played mahjong (a traditional Chinese board game) overnight, her ICD lead sense amplitude decreased suddenly and did not recover. The intracardiac electrogram of ICD also found ventricular lead noise before this episode. Chest radiography revealed a twisted lead at the ICD pocket and a twisted and retracted ICD lead in the right atrium. An old ICD lead could not be straightened and removed, and a new ICD lead was implanted at the right ventricle. Anti-coagulation was used to prevent thrombosis for the old ICD lead.

Keywords: Complication; Intracardiac defibrillator; Lead extraction.

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