Twiddler syndrome is an uncommon complication that occurs by twisting of the generator and may cause torsion, dislodgement, and injury of the leads. We report a rare case of a twiddler syndrome associated with an abdominal permanent pacemaker. Abdominal twiddler syndrome may possess a unique mechanism, which may not be seen in chest twiddler syndrome.
Keywords: abdominal distension; complication; epicardial lead; pacemaker; twiddler syndrome.