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The pace maker/reel-syndrome: rare cause of pace maker failure

Abubakar Hilal

Pacemaker lead dislodgment is a rare and disturbing cause of pacemaker malfunctioning. The displacement results by inadvertent physical manipulation of pacemaker pulse generator by the patient. This further proceeds into lead coiling, dislocation and pacemaker failure. In this study, a case report of an 80-year ischemic male who came to the hospital with dizziness, syncope and Brady arrhythmias is described. On examination, it was found that he had been previously implanted with PPM, 12 lead EKG was now showing third degree AV block. An urgent CXR was performed which showed ventricular lead retraction. Patient had accidently manipulated pacemaker resulting into subsequent coiling of the lead. On immediate basis, a TPM wire was inserted and set at 60bpm. Ventricular lead was repositioned and pulse generator was fixed to pectoral muscle. Patient was discharged successfully and remained stable after. Pacemaker lead repositioning is a life saving treatment along with proper suture fixation of the lead and pulse generator within patient’s pocket.