Extreme Intracardiac Coiling of a Transvenous Pacemaker; A Case Report

Abstract

We report an unusual complication of transvenous pacing: extreme coiling of a pacemaker catheter, which formed a redundant, twisted loop protruding into the right ventricular outflow tract. This may be a result of "twiddling" (rotation) of the pacemaker generator by the patient and/or inadequate fixation of the catheter at the venous entry site. Careful fixation of the generator to the venous entry site within the subcutaneous pocket may prevent such a complication.

Reel Syndrome and Pulsatile Liver in a Patient With a Two-chamber Pacemaker

“…It is usually observed close to the generator and sometimes intracardially. 4,5) It may cause lead dislocation or fraction and these in turn may cause life-threatening symptoms in patients with pacemaker dependence. 6,7) Reel syndrome is another form of Twiddler's syndrome.…”