Key result
Contralateral pacemaker reimplantation with compression successfully manages Reel syndrome presenting with complete heart block.
Case Report (n=1)
Reel syndrome, caused by pacemaker rotation in the sagittal axis, can be managed by explantation and reimplantation with proper pocket sizing and fascial suturing to prevent recurrence.
May support explantation-reimplantation for Reel syndrome with heart block; hypothesis-generating and requires validation in larger series.
Displacement of leads due to coiling around the pacemaker in the sagittal axis can result in Reel syndrome. Rotation of pulse generator can be due to self-manipulation, ratchet-like mechanism, or due to enlarged pocket. Our case presented with complete heart block with lead displacement and protrusion of pulse generator. Chest X-ray was suggestive of Reel syndrome. The pacemaker was explanted and implanted on the other side. To prevent recurrence, adequate pocket size was created with proper suturing to the underlying fascia and adequate compression for 5–7 days was applied after implantation.
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Rai et al. (2021) conducted a case report in Reel syndrome (n=1). Pacemaker explantation and contralateral reimplantation was evaluated. Pacemaker explantation and contralateral reimplantation with 5-7 days of compression successfully managed a case of Reel syndrome presenting with complete heart block.
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