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In Vivo Functional Study of Disease-associated Rare Human Variants Using Drosophila
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Reel syndrome-not a twiddler variant.

Mehul B Patel1, Khyati Pandya, Ashok J Shah

  • 1Thoracic and Cardiovascular Institute, Sparrow Health System, Lansing, MI 48910, USA.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|August 9, 2008
PubMed
Summary

We describe a rare "reel syndrome" causing single lead dislodgement in cardiac implantable electronic devices. This condition, distinct from twiddler syndrome, may be caused by a ratchet mechanism and can be prevented.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Device Technology

Background:

  • Cardiac implantable electronic devices (CIEDs), including dual-chamber and biventricular pacemakers, are crucial for managing heart rhythm disorders.
  • Lead integrity and proper function are paramount for effective CIED therapy.
  • Unforeseen lead complications can impact patient outcomes and device efficacy.

Observation:

  • Three cases of an unusual
  • reel syndrome
  • were identified, characterized by isolated, reeling dislodgement of a single lead.
  • This specific lead dislodgement occurred in patients with dual-chamber or biventricular devices.
  • One patient experienced worsening heart failure due to loss of left ventricular pacing; others were incidental findings.

Findings:

  • The observed lead dislodgement is a distinct entity, not a variant of the known
  • twiddler syndrome
  • .
  • A ratchet mechanism is suspected as the likely cause of this isolated, reeling lead dislodgement.
  • The findings highlight a novel complication associated with specific CIED configurations.

Implications:

  • Understanding this
  • reel syndrome
  • is essential for clinicians managing patients with CIEDs.
  • The proposed prevention strategy may reduce the incidence of this lead complication.
  • Further research into lead-device interactions and potential failure modes is warranted.