Reel Syndrome: A Variant Form of Twiddler's Syndrome

Reel syndrome is a variant form of twiddler's syndrome. We describe a 53 years old woman who was referred to our hospital because of symptomatic sinus bradycardia. Subsequently she underwent dual chamber pacemaker implantation and was sent back to the previous hospital on the following day. She was referred again because of sudden syncope due to low heart rate 2 weeks following implantation. Chest X-ray revealed leads had pulled out of the heart and coiled up around the pacemaker generator; a diagnosis of reel syndrome was made. The difference between the two syndromes, risk factors and preventive measures were discussed.