TY - JOUR T1 - Late twiddler syndrome in a patient with a submuscular implantable cardioverter defibrillator JF - BMJ Case Reports DO - 10.1136/bcr-2018-227162 VL - 2018 SP - bcr-2018-227162 AU - Neiberg de Alcantara Lima AU - Eduardo Arrais Rocha AU - Francisca Tatiana Moreira Pereira AU - Francisco daniel Cavalcante Y1 - 2018/09/15 UR - http://casereports.bmj.com/content/2018/bcr-2018-227162.abstract N2 - A 20-year-old woman with long-QT syndrome received a submuscular Fortify DR-St Jude implantable cardioverter defibrillator (ICD) after an episode of cardiac arrest. She felt an ICD pocket vibration 23 months later due to a high lead impedance and loss of capture. Chest radiography (figure 1A,B) showed both lead displacement and winding of the leads beside the ICD generator. These findings were confirmed during surgery (figure 1C). The patient strongly denied any box manipulation. She was discharged after new leads implantation with no complications.Figure 1 (A) and … ER -