The workshop was attended by over 120 cardiologists who specialise in implanting pacemakers nationally and Internationally from SAARC countries.
The technique utilizes the normal conduction system of the heart to pace it, which is not only a very good way of pacing the heart but also is very useful in patients with heart failure. (Representational image: IE)
For the first time in India, Fortis Hospital Gurugram conducted a live workshop of two cases to demonstrate the new technique of cardiac pacing. The new technique known as the ‘HIS Bundle Pacing’ or conduction system pacing was carried out by Internationally renowned eminent cardiologist and electrophysiologist, Dr TS Kler.
The workshop was attended by over 120 cardiologists who specialise in implanting pacemakers nationally and Internationally from SAARC countries. The technique utilizes the normal conduction system of the heart to pace it, which is not only a very good way of pacing the heart but also is very useful in patients with heart failure.
“This technique is also very useful in patients who have heart failure, where normally we used to do what is called cardiac resynchronization therapy by implanting three wires in the heart. Here the wire in the lower chamber of the heart is not implanted into the ventricular heart muscle, it is directly implanted on the conduction system. Either it is implanted on the HIS bundle or left bundle – So that the conduction of the electricity takes the normal conducting fiber of the heart. This is physiological and this prevents heart function from deteriorating in the future. So, if you pace the HIS bundle or the left bundle directly, the heart failure improves, and the pumping capacity of the heart improves. Our team has done 75 cases with the help of this new technique where the results have been very encouraging.” Explained Dr. TS Kler, Chairman, Fortis Heart & Vascular Institute, Gurugram and Fortis Hospital Vasant Kunj
Traditionally, if a patient has a heart block and needs a pacemaker, the doctors implant 2 wires in the heart, 1 in the right atrium and another in the right ventricle. The wire in the right ventricle is usually implanted at the bottom of the heart or in the septum, the division between the left and the right ventricle. This is a traditional type of cardiac pacing, but in the normal heart, the electrical wavefront or electrical system of the heart is such that the electricity travels from the right atrium to the base of ventricles and it travels lower down in a special conduction system, which is called as HIS Purkinje system.
“The deleterious effect of the traditional cardiac pacing is that the lower chambers of the heart get electrical stimulation from bottom to the base of the heart, that means it’s a reverse direction as compared to the electrical conduction in a normal human heart.” Added Dr Kler.
“During the workshop we successfully operated two cases of this complex procedure at Fortis Hospital, Gurugram. Both patients were implanted HIS bundle and Left bundle Pacing successfully with excellent parameters and have been discharged. In cardiology terms it is also referred to as a new method of making hearts beat (Pacing): Mimicking nature. With this workshop, we hope that this technique will be picked up by the other centers and the patients of India and SAARC countries will benefit from this technique.” Said Dr Avinash Verma, Senior Consultant, Electrophysiology, Fortis Hospital, Gurugram.