Sindrom 'twiddler' telah lama diketahui sebagai komplikasi pemasangan pacu-jantung. Sindrom tersebut ditandai dengan berputarnya lead atau kabel pada sumbu panjang generator pacu-jantung sehingga menimbulkan lilitan lead. Lead akan rusak, sehingga kawat putus atau terjadi bocor insulasi lead. Keadaan ini dapat menyebabkan lead terlepas dari tempatnya, stimulasi diafragma, gerakan tertentu lengan atas yang disebabkan oleh stimulasi pleksus saraf brakialis dan hilangnya fungsi pacuan ke jantung. Mengetahui faktor risiko terjadinya sindroma ini dan melakukan tindakan pencegahan merupakan hal yang sangat penting. Kami melaporkan seorang laki-laki berumur 84 tahun yang memutar generator pacujantung kamar tunggal secara tidak sengaja sehingga timbul sindrom 'twiddler' dalam waktu 2 bulan yang menyebabkan bocor insulasi lead sehingga baterei habis. Sepanjang pengetahuan penulis, ini merupakan laporan kasus pertama di Indonesia.
Reel syndrome is a variant form of twiddler's syndrome. We describe a 53 years old woman who was referred to our hospital because of symptomatic sinus bradycardia. Subsequently she underwent dual chamber pacemaker implantation and was sent back to the previous hospital on the following day. She was referred again because of sudden syncope due to low heart rate 2 weeks following implantation. Chest X-ray revealed leads had pulled out of the heart and coiled up around the pacemaker generator; a diagnosis of reel syndrome was made. The difference between the two syndromes, risk factors and preventive measures were discussed. (J Arrhythmia 2011; 27: 338-342)
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