How to Implant a Pacemaker for Reel Syndrome: A Method to Treat these Syndromes

Case Report

Austin J Clin Cardiolog. 2016; 3(2): 1051.

How to Implant a Pacemaker for Reel Syndrome: A Method to Treat these Syndromes

Kinoshita H¹*, Sugino H¹, Tanaka K¹, Harada T¹, Yuasa K¹, Shimonaga T¹, Ichikawa O¹, Oka T¹ and Matsuda M1,2

¹Department of Cardiology, National Hospital Organization, Japan

²Department of General Medicine, National Hospital Organization, Japan

*Corresponding author: Haruyuki Kinoshita, Department of Cardiology, National Hospital Organization, Kure Medical Center Chugoku Cancer Center, 3-1 Aoyama-cho, Kure-shi, Hiroshima 737-0023, Japan

Received: October 14, 2016; Accepted: October 25, 2016; Published: October 26, 2016


We report a case of an 83-year-old woman who deliberately tampered with the pacemaker’s placement site. We diagnosed this as Reel syndrome from clinical course. We wrapped a generator in a polytetrafluoroethylene sheet and affixed it to the large pectoral muscle at multiple points, other than the port, and prevented the generator from rotating in the longitudinal or horizontal direction intentionally from the body surface by the patient.

Keywords: Pacemaker dislodgement; Reel syndrome

Case Report

An 83-year-old female presented with the chief complaint of dizziness. She had a history of geriatric depression and delirium. A Dual-chamber (DDD) pacemaker had been implanted into her left breast and fixed to the greater pectoral muscle membrane for sick sinus syndrome when she was 81 years. In checking the pacemaker after eight months after the implantation, atrial sensing and pacing failure was discovered. Fortunately, the ventricular lead (V-lead) was functioning. Therefore, we continued to monitor it. Her dementia and depression turned worse to be progressive, and regardless of the repeated control of her daughter, she minded the pacemaker implanted place in her left chest and came to act tampering with it consciously from her body surface. One year after the first surgery, the V-lead dropped to the inferior vena cava, which could also be seen in the X-ray. The patient revealed that she had repeatedly rotated the generator from outside by herself. At first, we have been noticing only the dislodgement of the V-lead. However in half a year, we recognized the abnormal position of the atrial lead (A-lead) on the chest X-ray. We diagnosed this case as Reelsyndrome seeing theentangled lead image inside the pocket on the chest X-rays [1] (Figure 1). Reimplantation was considered because the patient experienced a symptom of light dizziness. We assumed that re-implantation inthe left breast might cause the patient to be nervous by fiddling with it in the dominant hand.

Citation: Kinoshita H, Sugino H, Tanaka K, Harada TYuasa K, Shimonaga T, et al. How to Implant a Pacemaker for Reel Syndrome: A Method to Treat these Syndromes. Austin J Clin Cardiolog. 2016; 3(2): 1051. ISSN : 2381-9111