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Life-saving Leadless Pacemaker Implanted in A 69-year-old Woman

A leadless pacemaker

Introduction

A leadless pacemaker is a small self-contained device that is implanted into the heart’s right ventricle. Pacemakers are used to treat patients who have bradyarrhythmias, which are slow heart rhythms caused by a problem with the heart’s conduction system (such as the SA node, AV node or His-Purkinje network).

Background

A 69-year-old pleasant lady was implanted with a permanent pacemaker 3 years ago for her complete heart block, and she returned with low Heart rates of 30/min. Dyspnea, drowsiness, and pedal edema were all present in a critical condition.

Ecg showed no pacing spikes and CHB on evaluation. 12.6 mg/dl S. Creatinine 6.8 mmol S. K

Discussion

A Temporary Emergency Pacemaker was implanted. Her potassium levels were corrected and she was put on dialysis and was stabilized. Despite more than a week of TPI support, she was unable to regain her Sinus Rhythm and remained TPI dependent.

RV Lead was found to be displaced on a CT scan of the chest. We intended to implant a new RV lead, but despite several attempts, we were unable to cannulate the left Subclavian Vein. The left Subclavian and Innominate veins were found to be occluded on an angiogram.

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Leadless Pacemaker

Leadless Pacemaker

Conclusion

In a suitable patient like this; Leadless Pacemaker can save lives where other options fail.

Advantages of Leadless pacemaker:  

  • Less Invasive non surgical  procedure 
  • No incisions or scar over the chest
  • Smallest size pacemaker device like a capsule weighing only 2.8 gms.
  • No involvement of wires, leads and pocket making .
  • Potential Risk of lead and device induced  complications , pocket infections avoided.

About Author –

Dr. Ashwin Tumkur, Consultant Interventional Cardiologist, Yashoda Hospital, Hyderabad
DNB (Peds), DNB (Cardiology), FESC (UK)

best Cardiologist in hyderabad

Dr. Ashwin Tumkur

DNB (Peds), DNB (Cardiology), FESC (UK)
Sr.Consultant Interventional Cardiologist

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