The Pacemaker-Twiddler's-Syndrome is a rare complication of transvenou
s pacemaker implantation. Since the first publication in the year of 1
968 Pacemaker-Twiddler's-Syndrome is characterized by rotation of the
pulse generator resulting in lead dislodgement and potential failure o
f the pacing system. Diagnostical, therapeutical and prophylactical me
thods for avoiding a life-threatening pacemaker malfunction are discus
sed.