A case of twiddler’s syndrome with a subcutaneous implantable cardioverter-defibrillator

Twiddler’s syndrome (TS) is twisting of the pulse generator in a cardiac implantable electronic device (CIED) pocket, either deliberately or unintentionally, resulting in lead displacement and device malfunction.1 TS with transvenous (TV) CIEDs has been well described, but there is limited data with subcutaneous implantable cardioverter-defibrillators (S-ICDs).