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Patient implanted with rv lead suffered from twiddler's syndrome.The physician opted to perform a device revision procedure to suture the device down in the pocket to prevent twiddling.Lead measurements were noted to be within normal limits prior to opening the device pocket.The pocket was then opened and the device was sutured to the pectoral muscle.The pocket was then closed and the lead was retested.The rv lead was no longer sensing in bipolar configuration and pacing impedance measurements were less than 200 ohms.Threshold measurements were noted to be stable, so sensing was reprogrammed to unipolar.It was noted that the device was programmed to left ventricular (lv) only pacing.This device remains in service.
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