Twiddler syndrome with 180° rotation of an implantable cardioverter defibrillator generator resulting in malfunction of one of the shocking coils
Bibliographic record
Abstract
A 78-year-old woman with non-ischaemic cardiomyopathy received a prophylactic single-chamber implantable cardioverter defibrillator (ICD) and later underwent device replacement for battery depletion (Current VR, St Jude Medical Inc., Saint Paul, MN, USA). During follow-up, the device was mobile in the pocket and there was evidence of traction of the lead (Panels A and B), but no evidence of lead malfunction. The patient was offered pocket revision which she declined. At the next follow-up, there was marked traction of the ICD lead and damage to the superior vena cava shock coil (Panels C and D). There was an extreme rotation of the ICD generator along the sagittal axis (180°). She underwent pocket revision and new ICD lead implantation. Conflict of interest: none declared. D.C. is partially funded by Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior (CAPES), Brazil.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".