PACEMAKER TWIDDLERS SYNDROME - REPORT OF A CASE

A patient with symptomatic atrioventricular blockage who had been trea ted by permanent pacemaker implantation, developed twiddler's syndrome 16 days after implantation. The electrode lead to the pacemaker pocke t had been completely displaced, with the electrode tip having moved t o the outside of the subclavian vein. Complete atrioventricular block was demonstrated by electrocardiogram. Reimplantation of the same elec trode at the apex of the right ventricle relieved the symptoms. The pa tient is regularly followed up at an outpatient clinic and continues t o be well. Although twiddler's syndrome is a rare complication of pace maker implantation, preventive measures should be undertaken especiall y for those judged to be at high risk.