Dog with pacemaker developed rare Reel Syndrome causing heart issues

Abstract

Reel Syndrome is a rare complication of permanent pacemaker implantation, characterised by the rotation of the device around its transverse axis, which causes the lead to coil around the generator and displacement, leading to pacing dysfunction. This report presents the first documented case of Reel Syndrome in a dog. The, 6‐year‐old female Labrador Retriever required a pacemaker implantation due to a diagnosed third‐degree atrioventricular block. Forty‐eight hours after pacemaker implantation, the dog developed clinical signs, including diaphragmatic contractions and a decrease in heart rate. Fluoroscopy confirmed the characteristic coiling of the lead around the generator, leading to a definitive diagnosis. Reel Syndrome can occur due to mechanical manipulation of the device by the patient, such as scratching or rubbing against objects as well as due to movement of the pacemaker system if it is not properly secured. Prevention involves securing the pacemaker and lead properly during implantation, ensuring close postoperative monitoring, and implementing protective measures such as an Elizabethan collar and pharmacological sedation to limit activity. Early diagnosis and intervention are crucial to prevent severe clinical consequences. This case highlights the importance of early recognition of Reel Syndrome and the need for proper stabilisation of the pacemaker and lead to prevent complications. Based on experience in human medicine, the described therapeutic approach may serve as a reference point for veterinary practice.