Parikh V, Barsoum EA, Morcus R, Azab B, Lafferty J, Kohn J. Unique presentation of Twiddler’s syndrome. World J Cardiol 2013; 5(6): 207-209 [PMID: 23802049 DOI: 10.4330/wjc.v5.i6.207]
Corresponding Author of This Article
Jeffrey Kohn, MD, FACC, Cardiac Electrophysiologist, New York Medical Associates, Department of Cardiology, New York University Langone Medical Center, New York, NY 10016, United States. kohn.jeff@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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World J Cardiol. Jun 26, 2013; 5(6): 207-209 Published online Jun 26, 2013. doi: 10.4330/wjc.v5.i6.207
Unique presentation of Twiddler’s syndrome
Valay Parikh, Emad A Barsoum, Rewais Morcus, Basem Azab, James Lafferty, Jeffrey Kohn
Valay Parikh, Emad A Barsoum, Rewais Morcus, Department of Medicine, Staten Island University Hospital, Staten Island, NY 10305, United States
Basem Azab, Department of Surgery, Staten Island University Hospital, Staten Island, NY 10305, United States
James Lafferty, Department of Cardiology, Staten Island University Hospital, Staten Island, NY 10305, United States
Jeffrey Kohn, Department of Cardiology, New York University Langone Medical Center, New York, NY 10016, United States
Author contributions: Parikh V, Barsoum EA and Morcus R were involved in drafting of manuscript; Azab B and Lafferty J have contributed in interpretation of data and critically revising the manuscript; Kohn J has contributed in interpretation of data, critically revising the manuscript as well as final approval.
Correspondence to: Jeffrey Kohn, MD, FACC, Cardiac Electrophysiologist, New York Medical Associates, Department of Cardiology, New York University Langone Medical Center, New York, NY 10016, United States. kohn.jeff@gmail.com
Telephone: +1-212-2492550 Fax: +1-212-2496856
Received: February 27, 2013 Revised: April 19, 2013 Accepted: May 17, 2013 Published online: June 26, 2013 Processing time: 121 Days and 2.8 Hours
Abstract
We present a rare case of Twiddler’s syndrome diagnosed in an asymptomatic patient on a routine follow up. This case reiterates the need for frequent monitoring of the implanted device. In addition, it was detected 4 years after implantation of an automatic implantable cardioverter defibrillator. This late representation is extremely uncommon.
Core tip: Our case points out few unique points to be remembered in regards to Twiddler’s syndrome: (1) Twiddler’s syndrome can present without any symptoms. Our case was diagnosed with the help of gradually increasing lead impedance. Ours is the first reported case of such a unique presentation; (2) Twiddler’s syndrome, although more common in first few months of implantation, can present very late; and (3) frequent monitoring of permanent pacemaker/automatic implantable cardioverter defibrillator is always needed.
