Re-exploration and lead replacement with an active fixation lead successfully restored pacemaker function and resolved recurrent syncope in an elderly female with pacemaker Reel syndrome at 6 months follow-up.
Case Report (n=1)
No
Reel syndrome is a rare cause of pacemaker lead macro-dislodgement that can present as recurrent syncope and may be managed effectively with lead repositioning or replacement with an active fixation lead.
Absolute Event Rate: 100% vs 0%
An elderly woman presented with recurrent syncope for two weeks. She had undergone a single-chamber permanent pacemaker implantation (PPI) two months ago. At presentation 12-lead electrocardiogram revealed complete heart block. Cinefluoroscopy revealed that the right ventricular (RV) lead had dislodged and was lying in the superior vena cava. On comparison with prior cinefluoroscopy, the pulse generator appeared to have rotated about its transverse axis, with leads coiled around the generator, consistent with Reel syndrome. The right-sided pocket was re-explored. The lead was seen to be coiled on top of the pacemaker generator. Right axillary venous access was taken, and an active fixation lead was implanted in the RV. She was discharged with instructions regarding careful arm movement.
Chopra et al. (Mon,) conducted a case report in Elderly, obese female patient in her 80s with complete heart block who underwent single-chamber permanent pacemaker implantation with cognitive impairment (n=1). Re-exploration and replacement of right ventricular lead with active fixation lead and secure placement of pulse generator vs. Initial tined right ventricular lead implantation was evaluated on Pacemaker function and symptom resolution following lead repositioning and replacement. Re-exploration and lead replacement with an active fixation lead successfully restored pacemaker function and resolved recurrent syncope in an elderly female with pacemaker Reel syndrome at 6 months follow-up.