Author Credentials

Mohamed Tashani, MD Marshall University


Twiddler's Syndrome, SSRIs, Psychiatric Disorder, AICD Malfunctioning


Medicine and Health Sciences


Twiddler’s syndrome is a rare condition caused by coiling of the leads, leading to a malfunction in the pacemaker or automated implantable cardioverter-defibrillator (AICD). It was first described by Bayliss in 1968 as a rare, but potentially fatal complication of pacemaker treatment1. Inappropriate shocks due to malfunctioning of the AICD can be devastating, traumatic, or fatal to the patient.

With traumatic inappropriate shocks, patients can develop stress or anxiety disorders in association with their AICD. Treatment for anxiety or acute stress disorder with medications can be difficult due to a patient’s underlying pro-arrhythmic conditions.

We are presenting a case report regarding a malfunctioning AICD that caused the patient to develop an acute stress disorder with worsening of her underlying anxiety disorder and the challenges posed by treating her.