Twiddler syndrome as a cause of defibrillator malfunction

Late twiddler syndrome in a patient with a submuscular implantable cardioverter defibrillator

“…However, predisposing factors include the creation of a large subcutaneous pocket, obesity, unconscious repetitive movements of the left arm, manipulation of the pocket or the adoption of repeated poor postural positions 3. Majority of cases were related during the first year of implant, but rarely can happen lately.…”