Twiddler syndrome and Reel syndrome in patients with subcutaneous implantable cardioverter-defibrillator (S-ICD): a meta-summary of case reports.

BACKGROUND

Twiddler and Reel syndrome are mechanical complications of transvenous devices and are rarely reported in subcutaneous ICD (S-ICD) recipients.

METHODS

We reviewed published cases and report Reel syndrome in a 15-year-old patient with an S-ICD, the youngest described.

RESULTS

Ten cases were identified. The most common clinical presentation was inappropriate shocks due to altered sensing vectors. Diagnosis was confirmed by device interrogation and chest radiography. Risk factors are similar to those observed in transvenous devices.

CONCLUSIONS

Twiddler and Reel syndrome can occur in S-ICDs and should be considered in the differential diagnosis of inappropriate shocks or device malfunction.