A rare complication about "Twiddler syndrome" is reported, and an interesting image about "double twist" is presented. A 78-year-old woman received a single-chamber implantable cardioverter defibrillator (ICD) for secondary prevention of ventricular arrhythmia. After she played mahjong (a traditional Chinese board game) overnight, her ICD lead sense amplitude decreased suddenly and did not recover. The intracardiac electrogram of ICD also found ventricular lead noise before this episode. Chest radiography revealed a twisted lead at the ICD pocket and a twisted and retracted ICD lead in the right atrium. An old ICD lead could not be straightened and removed, and a new ICD lead was implanted at the right ventricle. Anti-coagulation was used to prevent thrombosis for the old ICD lead.

报道了一种罕见的“Twiddler 综合征”并发症，并呈现了一幅关于“双绞”的有趣图像。一名 78 岁女性接受了单腔植入式心律转复除颤器 (ICD) 以用于室性心律失常的二级预防。打了一夜麻将后，ICD导联感幅度突然下降，没有恢复。本次发作前ICD的心内电图也发现心室导联噪声。胸片显示 ICD 口袋中的导线扭曲，右心房中的 ICD 导线扭曲和缩回。旧的ICD导联无法拉直取出，在右心室植入了新的ICD导联。抗凝剂用于防止旧 ICD 导线的血栓形成。