A Safer Option for a Patient with Multiple Complications

Patients with complex medical histories often face limited treatment options for cardiac rhythm disorders. At Kailash Hospital, Noida, Dr. (Prof.) D. S. Gambhir successfully managed a high-risk patient using a new-generation leadless pacemaker, avoiding life-threatening complications.

Presentation of Symptoms

A 72-year-old man presented with a complicated medical history. He had deep vein thrombosis (DVT), a history of prostate cancer, frequent episodes of loss of consciousness, and high-degree electric impulse conduction blocks. His low platelet counts further complicated the situation, making traditional pacing unsafe.

Diagnosis

The patient’s primary cardiac issue was severe conduction block, which disrupted the electrical signaling of the heart and caused repeated syncopal (fainting) episodes. His coexisting conditions made conventional pacemaker implantation highly risky.

Condition Overview

Patients with multiple systemic illnesses, such as DVT and cancer history, require extremely cautious management. The presence of an implanted IVC filter to prevent pulmonary embolism, combined with low platelet count, increased the risk of bleeding and procedural complications.

Treatment Plan

Given the high-risk factors, the medical team decided to implant a leadless pacemaker with new-generation active fixation technology. This minimally invasive device was delivered via catheter without the need for chest incisions or wires. Careful planning ensured that the IVC filter was not disturbed during the procedure.

Outcome and Follow-Up

The leadless pacemaker was implanted successfully, and the patient tolerated the procedure without complications. On follow-up, he demonstrated stable and effective pacing, with no recurrence of fainting episodes. His recovery was smooth, and he expressed satisfaction at regaining independence in daily activities.

Conclusion

This case emphasizes the importance of innovative pacing technologies in managing high-risk patients. Leadless pacemakers, by avoiding surgical pockets and wires, significantly reduce the risk of bleeding, infection, and device-related complications. The expertise of

Dr. Gambhir and his team at Kailash Hospital made it possible to treat a patient who otherwise had very limited options.