Institute of Clinical Medicine, College of Medicine, National Cheng Kung University.
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Int Heart J. 2021 Sep 30;62(5):1156-1159. doi: 10.1536/ihj.21-019. Epub 2021 Sep 17.
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.
报告了一例“Twiddler 综合征”的罕见并发症，并呈现了一个有趣的“双扭结”图像。一名 78 岁女性因室性心律失常二级预防而接受单腔植入式心律转复除颤器（ICD）治疗。在她通宵打麻将后，她的 ICD 导联感知幅度突然降低且未恢复。在此事件前，ICD 还发现了心室导联噪声。胸部 X 线片显示 ICD 囊袋处导联扭曲，右心房 ICD 导联扭曲并回缩。旧的 ICD 导联无法拉直并取出，在右心室植入了新的 ICD 导联。为防止旧 ICD 导联发生血栓形成，使用了抗凝治疗。
