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Europace Advance Access originally published online on August 29, 2007
Europace 2007 9(11):1061; doi:10.1093/europace/eum179
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© The European Society of Cardiology 2007. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

ICDS

An ICD lead with a twist after visiting the gym!

Reginald Liew* and Edward Rowland

Department of Cardiology, Atkinson Morley Wing, St Georges Hospital, Blackshaw Road, London SW17 0QT, UK

Manuscript submitted 27 May 2007. Accepted after revision 20 July 2007.

* Corresponding author. Tel: +44 07968 797766. E-mail address: r.liew{at}imperial.ac.uk

A 45-year-old man was admitted for a new ICD lead due to significant worsening of lead parameters (increase in impedance and decrease in amplitude) over several months. He had a single-chamber ICD inserted 1 year previously (in a subpectoral pocket) for an out-of-hospital VF arrest and also underwent percutaneous coronary intervention. The patient had since used the gym regularly and in particular performed a number of repetitive weight training chest exercises.

At surgery, the generator was mobile within the pocket and the lead found to be twisted around itself multiple times between the generator and suture sleeve, accounting for the shortening in length and consequent change in lead parameters. In total, 53 turns were required to straighten the lead. The lead was subsequently extracted without complication and a new lead inserted. The generator was sutured into the pectoral muscle and secured to prevent further torsion.

Twiddler's syndrome has been well described in patients with ICDs. This case represents a form of inadvertent, exercise-induced Twiddler's syndrome and highlights the importance of educating such patients on the type of exercise they can safely perform.

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This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
9/11/1061    most recent
eum179v1
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Right arrow Articles by Liew, R.
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