In a significant medical achievement, doctors at Aster RV Hospital in Bengaluru have successfully performed a rare leadless pacemaker implantation through the left jugular vein in the neck of an 85-year-old woman. The procedure, considered first of its kind in the city, offered a life-saving solution for a high-risk patient with complex medical conditions and limited access for conventional treatment.

The elderly patient was admitted to the hospital with cellulitis, a serious infection in her right leg, along with severe post-burn contractures affecting the groin and abdominal regions. These contractures had caused tight skin and significantly restricted vascular access, making standard cardiac procedures difficult.

Doctors said the patient had been experiencing persistent episodes of giddiness. Further evaluation through an electrocardiogram (ECG) revealed a complete heart block, a life-threatening condition in which the electrical signals controlling the heartbeat are disrupted. The condition required urgent permanent pacing to stabilize her heart rhythm.

According to her family, the patient had gradually become weaker over time and increasingly dependent on others due to her health condition, causing considerable anxiety and distress.

However, performing a conventional pacemaker implantation posed serious risks because of the patient’s ongoing infection and fragile skin condition. As an initial step, doctors carried out a right-leg debridement procedure to remove infected tissue and temporarily supported her heart rhythm with a temporary pacemaker.

Given the complexity of the case and the risk of infection, the cardiology team decided that a leadless pacemaker would be the safest treatment option. Leadless pacemakers are small self-contained devices implanted directly into the heart and do not require the traditional wires used in conventional pacemakers, reducing the risk of infection.

Normally, such devices are implanted through the femoral vein in the groin. However, due to the patient’s severe burn contractures and restricted access in the groin area, the standard route was not possible. The medical team therefore opted for an unconventional but potentially life-saving approach through the left jugular vein in the neck.

The complex procedure was carried out successfully under echocardiographic and fluoroscopic imaging guidance by a team of specialists including Dr. Bharathraj, Electrophysiologist, and Dr. G. Dimpu Edwin Jonathan, Consultant Interventional Cardiologist at Aster RV Hospital.

Dr. G. Dimpu Edwin Jonathan described the case as particularly challenging due to the patient’s active infection and severe post-burn skin contractures, which made traditional pacemaker implantation unsafe.

“The leadless pacemaker provided a minimally invasive and infection-resistant solution,” he said. “Choosing the left jugular route required meticulous planning and precision, but it enabled us to deliver life-saving therapy to the patient.”

Medical experts note that leadless pacemakers are increasingly becoming the preferred option for patients who face a high risk of infection or have limited vascular access. While implanting the device through the neck can present technical challenges during deployment, the procedure can be performed safely with advanced imaging technology and experienced specialists.

Following the implantation, the patient showed steady improvement. Doctors reported that her heart rhythm stabilized and her symptoms gradually subsided, allowing her to continue treatment for the leg infection and begin rehabilitation.

Hospital officials said the successful outcome reflects the institution’s commitment to delivering advanced and patient-centric cardiac care. They added that the procedure demonstrates how innovative and customized medical approaches can help treat complex cases that would otherwise pose significant challenges.