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IJN implants pacemaker in pregnant woman in pioneering surgery

KUALA LUMPUR: The National Heart Institute (IJN) has successfully implanted a pacemaker in a pregnant patient using a non-fluoroscopic imaging system.

Senior consultant cardiologist Dr Azlan Hussin said the procedure, which utilised virtual reality (VR) and was radiation-free, was the first of its kind ever performed in the country.

“We used magnetic field imaging instead of radiation to map the veins leading to the heart. We utilised VR to conduct the procedure.

“This is the first time this procedure has been carried out in Malaysia – but it has been done before in other countries like the United States,” he said at a press conference here yesterday.

Dr Azlan said that the 30-year old patient was referred to IJN after she was discovered to have a slow heartbeat rate of 30 beats per minute. (A normal heartbeat rate would be 60 to 80 pulses per minute).

He said the woman was assessed as requiring a pacemaker, as her slow heartbeat rate could complicate her delivery process due to low blood pressure and other factors.

Given that the patient was already in her sixth month of pregnancy, Dr Azlan and his team formulated a plan to develop a mapping pathway to her heart to determine how the catheter would enter – hence obviating the need for radiation, which would harm the foetus.

Dr Azlan said the procedure is more complicated than other heart procedures, but it was a challenge he and his team were eager to take on.

He said the operation on Monday lasted two hours, and the patient was discharged on Wednesday.

The usual procedure – known as fluoroscopy – uses radiation to map the passage of the catheter in order to place the pacemaker. But exposure to radiation could result in a range of health problems for the growing baby, he said.

Dr Azlan said the case was rare but the patient – a housewife from Manjung, Perak, said she now feels “slightly changed.”

“It is still too early to sum up her overall health, but I’m sure she will feel energised and better (as her pregnancy advances).

“Whether she will be able to deliver naturally or by Caesarean with the pacemaker in place will be totally up to her obstetrician,” he added.

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