Lead disposition of single chamber pacemaker – Reel Syndrome

Abstract

The Reel Syndrome is a rare condition of dysfunction of implantable electrocardiostimulator (pacemaker). The reason is retraction and twisting of the ventricular electrode around the pulse generatoron its transverse axis. This is induced by the manual manipulation of the pacemaker in its subcutaneouspocket from the side of the patient. The condition is observed in elderly patients with cognitive disturbancesand lack of insight for their own condition. The current article presents a clinical case of an elderlypatient – 85 years old with cognitive disturbances and implanted 6 months earlier single – chamberpacemaker who was presented with syncope and complete atrioventricular heart block, a consequenceof pacemaker dysfunction. The reason was retraction and twisting of the ventricular lead around the pulsegenerator – Reel Syndrome.