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

Twiddler's syndrome is characterized by coilinıg of the pacemaker lead due to the rotation of the pacem ak er generator on it s long axis. "Reel syndrome" is another form of Twiddler's syndrome. It occurs due to the rotation oftlıe pacemaker generator on i ts vertical axis witlı subsequent coi/ing of tlıe pacemaker generator on i ts vertical axis witlı subseqııent coiling of the pace1uaker leads around the pul se generator. In this report wedeseribed a patient w it/ı a two-clıamber pacemaker who presented w ith sudden onset abdominal pulsatian and subsequently diagnosed as Reel syndrome. Pacenıaker interrogatioıı slıowed effective atrial and ineffective ventricu/ar pacing. On chest X-ray. atrial lead was straightened. ventricular lead was in the vena cava