Reel syndrome: A rare case of pacemaker malfunction

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.