Twiddler's syndrome - Revision history

ClaireLewis at 18:41, 26 September 2019

2019-09-26T18:41:55Z

← Older revision		Revision as of 18:41, 26 September 2019
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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.
	*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.

	==Differential Diagnosis==		==Differential Diagnosis==
	*Lead separation		*Lead separation
	*Lead ~~dislodgment~~		*Lead dislodgement
	*Lead infection		*Lead infection
			*See also [[pacemaker malfunction]]

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Evaluation */

2019-02-26T03:24:04Z

Evaluation

← Older revision		Revision as of 03:24, 26 February 2019
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	==Evaluation==		==Evaluation==
	[[File:PMC3487215 APC-5-203-g002.png\|thumb\|]]		[[File:PMC3487215 APC-5-203-g002.png\|thumb\|Wrapped pacemaker lead showing Twiddler's syndrome.]]
	[[File:PMC4286824 JCIS-4-74-g022.png\|thumb\|]]		[[File:PMC4286824 JCIS-4-74-g022.png\|thumb\|Wrapped pacemaker lead showing Twiddler's syndrome.]]
	*[[CXR]] to evaluate the placement of the leads		*[[CXR]] to evaluate the placement of the leads

Rossdonaldson1: /* Evaluation */

2019-02-26T03:23:20Z

Evaluation

← Older revision		Revision as of 03:23, 26 February 2019
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	==Evaluation==		==Evaluation==
	[[File:PMC3487215 APC-5-203-g002.png\|thumb\|]]		[[File:PMC3487215 APC-5-203-g002.png\|thumb\|]]
			[[File:PMC4286824 JCIS-4-74-g022.png\|thumb\|]]
	*[[CXR]] to evaluate the placement of the leads		*[[CXR]] to evaluate the placement of the leads

Rossdonaldson1: /* Evaluation */

2019-02-26T03:21:20Z

Evaluation

← Older revision		Revision as of 03:21, 26 February 2019
Line 15:		Line 15:

	==Evaluation==		==Evaluation==
			[[File:PMC3487215 APC-5-203-g002.png\|thumb\|]]
	*[[CXR]] to evaluate the placement of the leads		*[[CXR]] to evaluate the placement of the leads

SLuckettG: /* Background */

2019-02-23T17:14:17Z

Background

← Older revision		Revision as of 17:14, 23 February 2019
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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 appropriate location in myocardium.		*Wires dislodged from appropriate location in myocardium, often by patient 'twiddling' a recently-implanted pacemaker.

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: Text replacement - "CXR" to "CXR"

2016-09-09T07:32:37Z

Text replacement - "*CXR" to "*CXR"

← Older revision		Revision as of 07:32, 9 September 2016
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	==Evaluation==		==Evaluation==
	*CXR to evaluate the placement of the leads		*[[CXR]] to evaluate the placement of the leads

	==Management==		==Management==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-26T08:02:45Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 08:02, 26 July 2016
Line 14:		Line 14:
	*Lead infection		*Lead infection

	==~~Diagnosis~~==		==Evaluation==
	*CXR to evaluate the placement of the leads		*CXR to evaluate the placement of the leads

Ostermayer: Text replacement - "Category:Cards" to "Category:Cardiology"

2016-03-22T13:53:57Z

Text replacement - "Category:Cards" to "Category:Cardiology"

← Older revision		Revision as of 13:53, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Cards~~]]		[[Category:Cardiology]]

Zipdoc at 19:55, 17 August 2015

2015-08-17T19:55:58Z

← Older revision		Revision as of 19:55, 17 August 2015
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	<references/>		<references/>

	[Category:Cards]		[[Category:Cards]]

Zipdoc at 19:55, 17 August 2015

2015-08-17T19:55:48Z

← Older revision		Revision as of 19:55, 17 August 2015
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	==Background==		==Background==
	*Implantable devices with attached wires traveling remotely are at risk.		*Implantable devices with attached wires traveling remotely are at risk for this complication.
	*Device moves within subcutaneous pocket pulling wires back to ~~device with intentional or unintentional movements~~.		*Device moves within subcutaneous pocket acting like fishing rod pulling wires back to the "pole."
	*Wires dislodged from ~~intended~~ location in myocardium.		*Wires dislodged from appropriate location in myocardium.

	~~[[File:Twiddler Syndrome.png\|thumb\|Twiddler Syndrome after large pocket and pacemaker wires spinning on themselves]]~~

	==Clinical Features==		==Clinical Features==
	*Pacemaker placed with poor function.		*Pacemaker placed with poor 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 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.		*Can present with symptoms related to stimulation of other structures (diaphragm, brachial plexus) as wires migrate from expected position.

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	*Lead separation		*Lead separation
	*Lead dislodgment		*Lead dislodgment
	*Lead infection		*Lead infection
	*Lead fracture

	==Diagnosis==		==Diagnosis==
	*CXR to evaluate the ~~lead location~~		*CXR to evaluate the placement of the leads

	==Management==		==Management==
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	==Disposition==		==Disposition==
	*Admit for device ~~revision~~		*Admit to allow for device intervention as pacemaker does not function in Twiddler's Syndrome

	==See Also==		==See Also==
	*[[Pacemaker complication]]		*[[Pacemaker complication]]

	==External Links==		==External Links==

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	<references/>		<references/>

	[[Category:Cards]]		[Category:Cards]

Twiddler's syndrome - Revision history

ClaireLewis at 18:41, 26 September 2019

Rossdonaldson1: /* Evaluation */

Rossdonaldson1: /* Evaluation */

Rossdonaldson1: /* Evaluation */

SLuckettG: /* Background */

Rossdonaldson1: Text replacement - "*CXR" to "*CXR"

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

Ostermayer: Text replacement - "Category:Cards" to "Category:Cardiology"

Zipdoc at 19:55, 17 August 2015

Zipdoc at 19:55, 17 August 2015

Rossdonaldson1: Text replacement - "CXR" to "CXR"