Surgeons at the Kauvery Hospital Heart City in Tiruchi have successfully implanted a leadless pacemaker — a self-contained generator and electrode system that is inserted in the right ventricle of the heart and is 90% smaller than the conventional device — in a 58-year-old male patient who was suffering from multiple episodes of pacemaker erosion since 2017.
Explaining the procedure that took place on February 5, at a press conference on Wednesday, T. Joseph, Interventional Cardiologist and Lead Electrophysiologist, Kauvery Heart City, said, “The patient had previously been implanted with a conventional lead pacemaker four to five times on both left and right side of the chest at a hospital elsewhere, which kept getting eroded. My team and I explained to the patient, the advantages of a leadless pacemaker — AV MICRA (Dual chamber) , which is an advanced device and non-allergic to patients. He agreed to go ahead with the implantation.”
The miniature device weighs less than nine grams and has a volume of 0.8cc, and is sent directly to the heart through a catheter. “It is implanted via a femoral vein transcatheter approach and requires no chest incision or subcutaneous generator pocket whereas, in a conventional pacemaker, the electrode system is placed in the pectoral area (chest) with wires connected to the heart. This technology turned out to be the best option for this particular patient,” said Dr. Joseph, who had used the same technology for a seven-year old child in 2020.
Commenting on the case, T. Senthil Kumar, Executive Director and Chief Cardio Thoracic-Vascular Surgeon, Kauvery Heart City said, “Allergic reactions to pacemaker device components are uncommon. However, when they occur, they usually mimic pacemaker infection, which results in multiple pacemaker replacements. This is what happened to the adult patient featured here. He approached us and we were able to provide him the better procedure that shall ensure that there no further complications in the future. Without the right treatment, these infections can be life-threatening — making it crucial to seek and find the highest level of care as soon as possible.”
The patient was discharged after being briefly kept under observation, the very next day after the implant surgery. He will however be visiting the hospital to get the device monitored over the coming months, said the surgical team.