Docs install second pacemaker in a cancer survivor

In a major surgery, doctors at a city hospital have installed pacemaker in the lower abdominal cavity of a 68-year-old woman who is also a cancer survivor.
The patient, Naseema Begum had come to the doctors at Fortis Escorts Heart Institute two years ago, when she had her first pacemaker implanted in the right heart cavity while she was suffering from cancer of the left breast.
Subsequently, the cancer spread to the right breast and caused infection which trickled to the pacemaker installed in her right heart cavity.
With a history of double mastectomy, it was a challenge for the doctors as there was no area in the chest or upper abdomen where the device could be re-implanted.

The team of doctors performed the surgery and implanted the pacemaker in an unusual location through the leg vein in the lower abdomen, also referred to as retro peritoneal way.
"For a two time cancer survivor, the patient has shown tremendous courage in surviving a series of illness. In this case, the patient had undergone cancer treatment and that compressed the area where implanting the device was more viable. So we had to take the retro peritoneal way," said Dr Aparna Jaswal, Senior Consultant in the Department of Cardiac Pacing and Electrophysiology.

Dr Somesh Mittal, Zonal Director, FEHI said that through this unusual route in implanting the device in the lower abdominal cavity, the doctors have continued to push new boundaries in medical excellence.

A pacemaker is a small device that is placed in the chest or upper abdomen to help control abnormal slow heart rhythms or arrhythmia. During an arrhythmia, the heart may not be able to pump enough blood to the body. This can cause symptoms such as fatigue (tiredness), shortness of breath, or fainting. Severe arrhythmias can damage the body's vital organs and may even cause loss of consciousness or death, said Dr Jaswal.
The pacemaker uses electrical pulses to prompt the heart to beat at a normal rate. In addition, the pulse generator attached to the pacemaker contains a small computer processor that can be programmed to set the rate of the pacemaker.

According to available data, approximately 20000 patients in India which has a population of over 120 million receive ICD implants every year. Medical tourism also constitutes for 7000 - 8000 pacemaker implants every year.