Reel Syndrome: an Unusual Complication of Cardiac Pacemaker Implantation

(A) Chest X-ray after pacemaker implantation (A). (B) Four days later, chest X-ray showed the displacement of the leads into the right atrium and the superior vena cava, with both the leads being wrapped around the pacemaker generator. (C) A few months later, a repeat chest X-ray showed a similar displacement of both the leads. A 67-year-old woman who underwent pacemaker implantation 4 days ago (A) consulted the emergency department with complaints of perception of muscle contractions on the right side of her chest. She did not have chest pain, dyspnea, or palpitations. Physical examination did not reveal any relevant findings. Electrocardiogram showed an absence of sensing or stimulation of the right atrium and right ventricle. Chest X-ray showed the displacement of the leads into the right atrium and the superior vena cava (B). Thus, she was referred to the cardiology department for lead repositioning.