Lead macro dislodgement (LMD) is an infrequent
post-implantation complication of CIED, with reported incidence of about
1-8%1-3. Reel syndrome is one type of
LMD4{Carnero-Varo, 1999, ReelSyndrome: a new form of
Twiddler’s syndrome?} (Twiddler and Rachet being other commonly known
syndromes)5. Unlike other varieties, the generator
rotates on its transverse/Z- axis in Reel syndrome resulting in lead
coiling around the device. Unlike Twiddler syndrome, leads are usually
not damaged in Reel syndrome. Older age, female gender, large device
pocket, compulsive generator manipulation or underlying psychiatric
history, obesity, and dementia3,6,are established risk
factors for LMD.