Indraprastha Apollo Hospitals Team Performs India’s First Leadless Pacemaker Implantation Through a Prosthetic Tricuspid Valve

Indraprastha Apollo Hospitals, New Delhi, has achieved a major milestone in cardiac electrophysiology by successfully performing India’s first leadless pacemaker implantation through a metallic prosthetic tricuspid valve. The complex procedure was led by Dr Vanita Arora, Clinical Lead – Cardiac Electrophysiology, and her team, offering a safe and minimally invasive solution for patients with challenging cardiac conditions.

Dr Vanita Arora (centre) with the cardiac electrophysiology team after performing India’s first leadless pacemaker implantation through a metallic prosthetic tricuspid valve.

The patient, a 65-year-old with a long history of cardiac illness, had previously undergone tricuspid valve replacement with a mechanical valve prosthesis. When he later developed symptomatic sinus node dysfunction and atrioventricular conduction disease, a permanent pacemaker was required to restore a stable heart rhythm. However, conventional pacemaker implantation was not feasible, as passing pacing leads through a mechanical tricuspid valve could damage the prosthesis and compromise valve function.

To address this challenge, the team implanted a dual-chamber leadless pacemaker using a catheter-based approach through a vein in the leg. Unlike traditional pacemakers, leadless systems are compact, self-contained devices placed directly within the heart, eliminating the need for pacing leads and surgical pockets. This approach reduces the risk of infection, device-related complications, and interference with prosthetic valves.

The procedure was carefully planned using advanced cardiac mapping and precise device positioning to restore heart rhythm while preserving the function of the prosthetic valve. The patient recovered well and was discharged in stable condition.

This landmark intervention highlights the expanding role of leadless pacing technologies in managing complex cardiac rhythm disorders and reinforces Apollo Hospitals’ commitment to advancing innovation in cardiovascular care.