Jahangeer Ganaie
Anantnag, Dec 31 : Government Medical College (GMC) Anantnag has made history by performing 50 cases of “LBB-A pacing” (a novel technology) under a C-arm within just four months, without EP backup.
The feat, according to the news agency, was achieved under the patronage of Principal GMC Anantnag, Prof Dr Rukhsana Najeeb and the cardiology team comprising Dr Syed Maqbool, Dr Shamim Iqbal and Dr Showkat Hussain Shah.
The journey began in September 2024, when the team decided to replace conventional pacemaker implantation with LBB-A pacing. Despite numerous constraints and hurdles, the programme has continued uninterrupted to this day.
In conventional pacemaker implantation, the pacing lead is implanted at the RV apex/septum, pacing the RV muscle. This method can lead to pacemaker-induced cardiomyopathy in 10-20% of individuals within 3-4 years post-PPM insertion, potentially resulting in 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. By pacing the conduction system, this technique completely eliminates the risk of heart failure associated with conventional RV pacing. LBB-A pacing, which started in 2017, has gained global acceptance and is practised in many institutions across the country, including in the Union Territory of Jammu and Kashmir.
“Globally, most cardiologists perform this procedure in a cath lab with EP guidance. However, GMC Anantnag has not only managed to conduct the procedure without EP backup but has also become the only institution in the world to perform it under a C-arm, a remarkable feat given the challenges involved. It is worth mentioning that GMC Anantnag has also performed the highest number of LBB-A pacing cases in Jammu and Kashmir to date,” Dr Rukhsana said.
She said this technology is not limited to patients with complete heart block and sick sinus syndrome. It is also highly beneficial for patients with DCM, LBBB, and other conditions, rapidly replacing conventional CRTP implantation, she added.
Principal GMC Anantnag said the institution has performed a record 50 cases in just four months, including patients with conditions such as DCM/LBBB, HCM, and complete heart block or sick sinus syndrome. “The patient spectrum ranged from young to elderly individuals with comorbidities like heart failure, diabetes, CKD, CLD, and malignancy. The success rate was approximately 95%, with no reported mortality,” she said.
LBB-A pacing is technically more demanding than conventional pacemaker implantation and involves a significant learning curve. Starting this advanced procedure at a peripheral institution like GMC Anantnag—without a cath lab or EP backup—was no easy task, Prof Jabeen said. “However, the cardiology team at GMC Anantnag was determined to overcome all challenges to achieve this milestone. The team worked tirelessly, often starting early and continuing late into the evening, far beyond regular duty hours,” she said, adding, “The technical staff of the OT and medical ICU also played a pivotal role in making this program a success.”
Principal Dr Jabeen, who supported the programme from its inception, congratulated the cardiology team for their “extraordinary achievement” and reiterated her commitment to working with zeal and dedication to make GMC Anantnag one of the premier medical colleges in the country
