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Now, MRI Possible in Those with Implanted Pacemaker

In a first-of-its kind procedure in this part of Haryana, a team of experts, led by senior interventional cardiologists Dr Amit Taneja and Dr Deepak Chopra, Cygnus Maharaja Aggarsain Hospital, Panipat, implanted a CRT-D (Cardiac Resynchronization Therapy Defibrillator) in a 54-year-old man suffering from cardiomyopathy (a disorder of the heart where heart muscles become weak) and was breathless on walking or working despite optimal medical therapy.

The device implanted is a pacemaker, and is an MRI-compatible device. This new-generation instrument synchronizes the muscles of the heart, in case of weak pumping of heart. This could prevent future heart failures, sudden cardiac deaths, and give patients an overall better quality of life than previously had.

“The surgery lasted about two hours, and it was a technically challenging procedure. This is because, besides the actual implanting, the programming of the device is the most important, and this needs technical expertise. The device, that weighs about 80 grams, is implanted on the left side of the heart, just below the collar bone. The cut made for the surgery is not more than 3 cm long and the patient can go home in a few days' time. Recovery is quick, and people get back to their lives, without the feeling of breathlessness and fatigue. The wound heals in about two weeks, and the procedure is done under local anesthesia,” says Dr Taneja.

Cardiac resynchronization therapy is the resynchronization of heart muscles that are functioning out of sync with each other. So the left and right walls of the left chamber are not contracting and relaxing together. This gives rise to the less effective pumping of the heart, which in turn cause breathlessness and fatigue. The reasons for this can range from heart attacks, congenital (birth) defects, myocarditis (inflammation) to idiopathic (unknown) reasons. Those with an ejection fraction (EF) lower than 35% are at risk for heart failure and have a 5-6 times greater chance of sudden cardiac death. Hence, these patients are usually advised to opt for a CRT-D device. (EF is the fraction of blood pumped out of the heart, and this should ideally be 60%.)

“People are now opting more and more for this MRI-compatible device, as they can now undergo an MRI when required. MRIs were previously not done in patients with pacemakers. MRI-compatible ones have been launched in India only recently. The life of the battery of the CST device is 6-8 years, after which it is replaced with a minor surgery. This is the first time we have done this in this part of Haryana. We are happy that technological advancement is helping more and more people attain a better quality of life. However, it is important for patients to understand that medication, exercise, a healthy diet, and regular check-ups are all to be followed, as instructed by the doctor,” says Dr Chopra.

The patient is doing well, his symptoms have improved, and ejection fraction has also increased.

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