Unique presentation of Twiddler's syndrome.

We present a rare case of Twiddler's syndrome diagnosed in an asymptomatic patient on a routine follow up. This case reiterates the need for frequent monitoring of the implanted device. In addition, it was detected 4 years after implantation of an automatic implantable cardioverter defibrillator. This late representation is extremely uncommon.

[1]  A. Manolis,et al.  Twiddler's syndrome , 2011, Acute cardiac care.

[2]  A. Seifi,et al.  Follow your leads: a case of twiddler's syndrome. , 2009, Southern medical journal.

[3]  F. Regoli,et al.  Images in cardiovascular medicine. Hiccups and dysphonic metallic voice: a unique presentation of Twiddler syndrome. , 2006, Circulation.

[4]  M. Josephson,et al.  Twiddler's Syndrome Variants in ICD Patients , 1998, Pacing and clinical electrophysiology : PACE.

[5]  B. Avitall,et al.  Sudden cardiac death: Twiddler's syndrome with an implantable cardioverter defibrillator. , 1994, American heart journal.

[6]  P. R. Reid,et al.  Twiddler's Syndrome: A New Twist , 1984, Pacing and clinical electrophysiology : PACE.

[7]  D. Beanlands,et al.  The pacemaker-twiddler's syndrome: a new complication of implantable transvenous pacemakers. , 1968, Canadian Medical Association journal.