GMC Anantnag Makes History with 50 LBB-A Pacing Cases Under C-Arm

GMC Anantnag Creates History; Becomes the Only Institution in the World to Perform 50 Cases of LBB-A Pacings Under C-arm

Anantnag, Dec 31 (KF): Under the patronage of Principal GMC Anantnag, Prof. Dr. Rukhsana Najeeb, the cardiology team of GMC Anantnag, including Dr. Syed Maqbool, Dr. Shamim Iqbal, and Dr. Showkat Hussain Shah, made history by performing 50 cases of “LBB-A pacings” (a novel technology) under C-arm in just four months without EP backup.

The journey began in September 2024 when the team decided to replace conventional pacemaker implantation with LBB-A pacing, and it continues to this day despite numerous constraints and hurdles.

In conventional pacemaker implantation, the pacing lead is implanted at the RV apex/septum and paces the RV muscle, which can lead to pacemaker-induced cardiomyopathy in 10-20% of individuals within 3-4 years of pacemaker 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 widely used around the world, including in many institutions across the country and the UT of Jammu and Kashmir.

Most cardiologists globally perform the procedure in a cath lab 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 is the only institution in the world performing it under C-arm, which is a real challenge. Additionally, GMC Anantnag has performed the highest number of LBB-A pacings in the UT of Jammu and Kashmir.

In addition to treating complete heart block and sick sinus syndrome, this technology is also useful for patients with DCM/LBBB and is rapidly replacing conventional CRTP implantation. The institution has performed a record 50 cases in just four months, which included not only patients with complete heart block and sick sinus syndrome but also a substantial number of patients with DCM/LBBB, and a few cases of HCM. The patients ranged in age and had comorbidities such as heart failure, diabetes, CKD, CLD, and malignancy. The success rate was around 95%, with no 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, especially without a cath lab and EP backup, was not an easy task. However, the cardiology team at GMC Anantnag was committed and determined to overcome all obstacles to achieve this remarkable feat. The team worked tirelessly, starting early and continuing well into the evening, beyond regular duty hours, in all circumstances. The technical staff of the OT and Medical ICU worked alongside the cardiology team to make this success story possible.

Principal GMC Anantnag, Prof. Dr. Rukhsana Najeeb, supported the program from the very beginning, demonstrating her zeal and commitment to improving superspecialty healthcare in South Kashmir.

Prof. Dr. Rukhsana Najeeb congratulated the trio for this extraordinary achievement and reiterated her dedication to helping GMC Anantnag become one of the best colleges in the country. (KF)