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Pacemaker implanted in six-day-old infant

In a first of its kind procedure in the country, a pacemaker was implanted in a six-day-old infant at Jehangir Hospital here.

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PUNE: In a first of its kind procedure in the country, a pacemaker was implanted in a six-day-old infant at Jehangir  Hospital here.

''This condition is extremely rare in newborn babies and is due to a defect in the conducting system of the heart muscles, which control the rate of pumping of the heart.

Due to the heart blockage, the baby was on the ventilator and weaning it away from the ventilator was not possible. We decided to implant a permanent pacemaker, while still on the ventilator,'' said Dr J S Duggal, Head (Cardiology) of Jehangir Hospital, here on Tuesday.
 
''This procedure is extremely difficult in a newborn and is probably the first time it has been performed in the country,'' he added.
 
''The infant, baby of Avinash and Vandana Rathod, was born with a heart blockage on September 16. This resulted in the pulse rate being barely 50-60 beats per minute. (Normal pulse rate is 120 to 130 beats per minute in infants). As a result, the baby had a difficulty in breathing as its heart was unable to keep up with the body's requirements, and therefore, it was on the ventilator from birth,'' informed Dr Anshu Sethi, Neonatologist.
 
''In adults, it is a simple procedure done under local anesthesia, wherein the pacemaker is implanted through subclavian vessels and not directly onto the heart.

However, in this case, the infant's age and tiny blood vessels posed a huge challenge and neccessitated a major cardiac surgery, which was carried out under general anesthesia. And a permanent pacemaker was implanted directly onto the heart, while the baby was still on ventilator,'' said Dr Manoj Pradhan, Chief Cardiac Surgeon of Jehangir Hospital.
 
''Immediately after the procedure, the heart rate increased to 135 beats/minute and within 6 hours, the child was weaned off the ventilator and was comfortably breathing on his own. Within the next 24 hours, the baby was given regular feeds and was discharged 6 days after his surgery, Dr Sethi said.
 
When asked whether the infant will lead a normal life, Dr Pradhan said they were confident that the results would be good, as the pacemaker would monitor the required rate when the child begins with any physical activity.

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