Abstract
The pacemaker twiddler's syndrome, as reported by Bayliss and his associates, was described.
Axial rotation of a Devices pulse generator in the subcutaneous pocket was noted 5 weeks after implantation in a 85 year old patient. Axial rotation was diagnosed due to the appearance of twitching of the underlying muscles and confirmed by the unpalpable anodal plate and lateral chest films.
The factors to cause this complication were discussed.
The coverage of pulse generator with tetoron mesh and fixation to the surrounding tissues in the pocket have prevented further rotation.
The shape and design of the Devices pulse generator may be a causative factor to axial rotation in a rather capacious subcutaneous pocket.
