Under the patronage of Principle GMC Anantnag Prof. Dr. Rukhsana Najeeb, cardiology team of GMC Anantnag, including Dr. Syed Maqbool, Dr. Shamim iqbal and Dr. showkat Hussain Shah recorded history by performing 50 cases of “LBB-A pacing’s” (a novel technology) under C-arm in just 4 months without EP backup.
The journey started in September 2024, when the team decided to replace conventional pacemaker implantation by LBB-A pacing and continues unabated to date despite many constraints and hurdles.
In conventional pacemaker implantation, the pacing lead is implanted at RV apex/septum and paces RV muscle, which can lead to Pacemaker induced cardiomyopathy in 10-20% of individuals within 3-4 years post PPM insertion.This can cause heart failure, recurrent hospital admissions, and even death.
LBB-A pacing is a novel technology wherein the pacemaker lead paces the normal conduction system of the heart rather than the RV muscle. Pacing the conduction system completely alleviates the complication of heart failure associated with conventional RV pacing. LBB-A pacing started in 2017 and is in vogue world over, including many institutions of the country as well as the UT of jammu and kashmir.
Most of the cardiologists all across the globe do it in a cathlab and under EP guidance. However, at a few places in the world, it is being done without EP backup. GMC Anantnag not only does it without EP backup, but it is the only institution in the world doing it under C-arm, which is a real challenge. It will be pertinent to mention here that this institution, also to date, has done the highest number of LBB-A pacing’s in the UT of jammu and kashmir.
In addition to complete heart block and sick sinus syndrome, this technology is also very useful in patients with DCM/LBBB and is rapidly replacing the conventional CRTP implantation.The institution has done a record no of 50 cases in just four months, which included not only patients with complete heart block/sick sinus syndrome but a substantial number of DCM/LBBB and a few cases of HCM. It was a spectrum of patients including, young, old, with comorbidities like heart failure, diabetes, CKD, CLD, and malignancy. The success rate was around 95% and without any mortality.
LBB-A pacing is technically more demanding than conventional pacemaker implantation and has a learning curve.
Starting LBB-A pacing at a peripheral institution like GMC Anantnag and that too without a cathlab and EP backup was not an easy job.The cardiology team at GMC Anantnag was firm in their belief and determined to overcome all hurdles to achieve this feat. The team would start early and work till late evenings much beyond the stipulated duty hours and in all circumstances.The technical staff of the OT and medical ICU worked alongside tirelessly to make it a success story.
Principal GMC Anantnag Prof Dr Rukhsana Najeeb supported the program the program outright, right from the day of its inception, which depicts her zeal and commitment for improving superspeciality healthcare in South kashmir.
Principal GMC Anantnag congratulated the trio for this extraordinary achievement and reiterated that she will continue to work with all the zeal and dedication to help GMC Anantnag to be become one of the best colleges in the whole country.
