Síndrome de twiddler en paciente con trastorno obsesivo compulsivo tratado mediante estimulación cerebral profunda

Moliz, Nicolas; Katati, Majed J.; Iañez, Benjamín; Garcia, A. P. U.; Yagui, Eskandar; Horcajadas, A.

doi:10.1016/j.neucir.2014.11.001

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…In two recently published case reports, a correlation has been made between obsessive–compulsive disorder (OCD) and TS, 6 , 7 but in both cases, patients underwent the implant of neurological/brain stimulation devices in order to treat neurological and psychiatric disorders.…”

Section: Discussionmentioning

confidence: 99%

A case series of the twiddler syndrome

Montisci,

Soro,

Demelas

et al. 2023

European Heart Journal - Case Reports

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Background Twiddler Syndrome (TS) is a complication of cardiac implantable electronic devices (CIED) implantation, caused by the deliberate or unconscious manipulation of the device by the patient himself, which results in dislocation of the leads by retraction towards the subcutaneous pocket. Case Summary This report describes two clinical cases that occurred in our center, for which two different solutions were successfully implemented. In the first case a complete removal of the stimulation system was performed and a leadless PM (Medtronic Micra VR) was implanted. In the second case the patient underwent a revision procedure. The pacemaker was disconnected, and the electrodes were debrided, a sub-muscular pocket for the PM was created and at the end of the procedure the pacemaker was anchored to the pectoralis major. Discussion TS is a rare and serious complication of CIED implantation, leading to device malfunctioning and higher risk of infection of the pocket due to multiple re-interventions. In these two cases, different surgical solutions were performed, both resulting to be effective to solve the effects of TS.

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Section: Discussionmentioning

confidence: 99%

A case series of the twiddler syndrome

Montisci,

Soro,

Demelas

et al. 2023

European Heart Journal - Case Reports

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“…When treating patients with TS, it is important to evaluate for psychiatric conditions, as many correlations have been documented with OCD and other picking disorders [16,17]. Implantable device shape should be considered, as elongated devices have been linked with spontaneous rotation [18].…”

Section: Discussionmentioning

confidence: 99%

Erosive Twiddler’s Syndrome: A Severe Case with Externalization of the Pacemaker

Stuart

Gilbert

Valencia

2020

Cureus

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Implantable pacemakers have been the mainstay of therapy for patients with severely decreased left ventricular ejection fractions and recurrent arrhythmias, among other cardiac pathology. Twiddler's syndrome (TS) is an uncommon but potentially life-threatening complication of pacemaker therapy, defined as pacemaker malfunction in the setting of device lead dislodgment due to physical manipulation. Traditionally, there are three distinct TS variants (reeling, ratchet and coiling). This case offers evidence of a unique and new variant of TS, severe recurrent erosive subtype with pacemaker externalization.

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