Government Medical College (GMC) Anantnag has made history by becoming the only institution in the world to perform 50 cases of Left Bundle Branch Area (LBBA) Pacing under a basic C-arm X-ray machine, all within just three months and without specialized Electrophysiology (EP) lab support.
The achievement was led by GMC Anantnag’s cardiology team, comprising Dr. Syed Maqbool, Dr. Shamim Iqbal, and Dr. Showkat Shah. Dr. Maqbool shared that the journey began in mid-September 2024 when the team opted to replace traditional pacemaker implantation with LBBA pacing. Despite facing significant challenges, the team’s dedication to providing advanced care has resulted in this unprecedented milestone.
Dr. Maqbool credited the success to the support of Prof. Dr. Rukhsana Najeeb, Principal of GMC Anantnag. “This achievement wouldn’t have been possible without her guidance,” he said.
In just three months, the cardiology team at GMC Anantnag performed 50 LBBA pacing procedures, treating a diverse range of conditions, including Complete Heart Block, Sick Sinus Syndrome, Dilated Cardiomyopathy (DCM) with Left Bundle Branch Block (LBBB), and some cases of Hypertrophic Cardiomyopathy (HCM). The patients varied in age and complexity, with many suffering from additional health conditions such as heart failure, diabetes, kidney disease, liver disease, and even cancer. The team achieved a 95% success rate with no reported deaths, demonstrating both their skill and the effectiveness of the procedure.
Performing LBBA pacing in a peripheral hospital like GMC Anantnag, which lacks a cath lab or EP backup, is no small feat. The procedure is technically complex and requires significant expertise. Dr. Maqbool emphasized that the cardiology team worked tirelessly, often extending their hours to meet the demands of the patients.
The success of the procedure was made possible with the support of the technical staff in the operating theatre and medical ICU, who worked closely with the doctors. The achievement is seen as not only a milestone for GMC Anantnag but also for the Union Territory of Jammu and Kashmir, where the institution now holds the highest number of LBBA pacing cases performed.
LBBA pacing is rapidly replacing traditional RV pacing and even Cardiac Resynchronization Therapy Pacemakers (CRT-P) in many cases. The procedure has shown great promise in improving outcomes for patients with heart block, heart failure, and conduction system diseases, making it a revolutionary advancement in cardiology.
Officials at GMC Anantnag stated that the hospital’s success in performing LBBA pacing highlights how determination and innovation can overcome resource limitations. This milestone is expected to inspire other institutions to adopt newer, life-saving technologies, even in resource-constrained settings.
Looking ahead, GMC Anantnag plans to further upgrade its surgical and cardiac care services, aiming to provide comprehensive healthcare to the people of South Kashmir, who previously had to travel to Srinagar for such treatments.
What is LBBA Pacing?
LBBA pacing is a more advanced method compared to conventional pacemaker implantation, which places the pacemaker wire in the right ventricle (RV). Although effective initially, RV pacing can lead to complications like Pacemaker-Induced Cardiomyopathy (PICM), which affects 10-20% of patients within 3-4 years, potentially leading to heart failure and repeated hospitalizations. In contrast, LBBA pacing uses the heart’s natural conduction system to transmit electrical signals, ensuring a more efficient and natural way to maintain a normal heartbeat.
First introduced in 2017, LBBA pacing is now widely adopted globally, but typically requires a fully equipped cath lab with EP support. GMC Anantnag stands out as the only institution globally performing the procedure under a basic C-arm X-ray system, showcasing remarkable expertise and resourcefulness.
