TNI Bureau: An elderly lady was suffering from recurrent reeling of head (presyncope). She was diagnosed as a case of Sick Sinus Syndrome with symptomatic bradycardia and at the time of admission in emergency department her heart rate was as low as twenty-two per minute. She was planned for permanent pacemaker implantation (PPI).
Pacemaker has two components, a Battery (pulse generator: PG) and leads (wires that connect battery with the heart chambers). Usually, these leads go through the subclavian veins and the PG (battery) is inserted in chest area beneath the skin by making a pocket.
If there is any disease or problems at chest area and chest veins (subclavian veins) PPI could not be done. Sometimes open heart surgery with epicardial lead implantation is the only option.
This lady had history previous surgery at chest area, chemotherapy and radiotherapy. For above reasons the chest area and chest veins were not suitable for usual PPI. Recently with advancement of technology we have another option that is “Leadless Pacemaker.”
Leadless pacemaker is the smallest pacemaker till date with the size as small as one rupee coin.
It has no lead, and the tiny Battery (PG) is directly placed inside the heart chamber to pace the heart.
A team of doctors led by Dr Dibya Ranjan Behera have done this leadless pacemaker implantation successfully at Amri Hospital, Bhubaneswar. The lady was discharged in stable condition. This is the first such case in Àmri Hospital Bhubaneswar and one of the first few cases of our State. This leadless pacemaker definitely is a ray of hope for such patients.