Twiddler's syndrome The Lancet Volume 382, Issue 9909, (December 2013) Dr Jackson J Liang, DO, Eric R Fenstad, MD  The Lancet  Volume 382, Issue 9909, (December 2013) DOI: 10.1016/S0140-6736(13)61419-1 Copyright © 2013 Elsevier Ltd Terms and Conditions

Figure Twiddler's syndrome (A) Chest radiograph immediately after implantation of right-sided dual-chamber permanent pacemaker with leads appropriately positioned in the right atrium and right ventricle. (B) Chest radiograph on patient presentation showing generator rotation with winding of the leads around the pacer pack and retraction of both leads to the level of the cavoatrial junction. The Lancet 2013 382, DOI: (10.1016/S0140-6736(13)61419-1) Copyright © 2013 Elsevier Ltd Terms and Conditions