Advanced Cardiac Care with Leadless Pacemaker Implantation at Kailash Hospital

Cardiac rhythm disorders in elderly patients can be life-threatening, especially when associated with multiple comorbidities and a history of heart disease. Timely diagnosis and advanced interventional cardiology can significantly improve patient outcomes.

At Kailash Hospital, Greater Noida, an elderly female patient with a complex cardiac history was successfully treated under the expert care of Dr. Sunil Kumar Mandal, Consultant Cardiologist, using advanced leadless pacemaker technology.

Presentation of Symptoms (if any)

The patient was admitted with:

• Multiple episodes of syncope (fainting)
• Sensations of uneasiness and ghabrahat
• Associated symptoms suggesting cardiac rhythm disturbance

Given her age and cardiac history, these symptoms indicated a serious underlying conduction abnormality requiring urgent evaluation.

Diagnosis

Detailed investigations including ECG and 24-hour Holter monitoring revealed:

• Intermittent 2:1 Atrioventricular (AV) Block
• Episodes of bradycardia with intermittent pauses

The patient also had a significant past cardiac history, including:

• Coronary Artery Disease (Double Vessel Disease)
• Previous angioplasty (PTCA) with stent placement
• History of Coronary Artery Bypass Grafting (CABG)
• Hypertension and reduced cardiac function (LVEF ~ 50%)
• Elderly frail female with cachexia

Condition Overview

A 2:1 AV block is a serious heart rhythm disorder where only half of the electrical impulses from the atria reach the ventricles, leading to slow heart rate and reduced blood flow to vital organs.

In elderly patients, especially those with prior cardiac interventions, such conduction abnormalities can result in recurrent syncope, fatigue, and increased risk of sudden cardiac events.

Management often requires implantation of a permanent pacemaker, and newer technologies like leadless pacemakers offer safer and less invasive alternatives.

Treatment Plan

Under the supervision of Dr. Sunil Kumar Mandal, a comprehensive treatment strategy was implemented:

1. Initial Stabilization & Monitoring

• Admission to cardiac care unit (CCU)
• Continuous ECG and vital monitoring
• Evaluation of cardiac function through echocardiography

2. Medical Management

• Supportive treatment for associated conditions (infection, electrolyte imbalance, etc.)
• Optimization of cardiac medications

3. Leadless Pacemaker Implantation (Micra AV2 -Medtronic)

• A dual-chamber leadless pacemaker was implanted
• Minimally invasive procedure without traditional leads or surgical pocket
• Designed to restore normal heart rhythm and prevent further syncopal episodes

4. Post-Procedural Care

• Monitoring for device function and rhythm stability
• Mobilization and supportive care
• Ongoing evaluation of cardiac performance
• Discharged on next day of procedure

Outcome and Follow-Up

Following the procedure, the patient showed significant clinical improvement. Episodes of syncope resolved, and heart rhythm stabilized effectively.

Her cardiac function improved, and she remained hemodynamically stable throughout hospitalization.  She was discharged in stable condition on next day of procedure with advice for regular follow-up and continued cardiac care.

Conclusion

This case highlights the importance of early recognition of cardiac conduction disorders and the role of advanced technologies like leadless pacemakers in improving patient outcomes—especially in elderly individuals with complex cardiac histories. Leadless Pacemaker is an advance and safe alternative without any surgical incision and pocket creation. Chances of infection is very low and hospital stay is short in compare to conventional pacemaker.

At Kailash Hospital, the integration of expert cardiology care, modern interventional techniques, and patient-centric management ensures successful treatment of even high-risk cardiac conditions.