First time in Tamil Nadu, doctors’ team at Meenakshi Mission Hospital and Research Centre (MMHRC) performed a novel approach called Stellet Driven LOT ICD to save a 58-year-old woman. She had been suffering from LV dysfunction and Shortness of breath SOB even at rest for the past 5 years. She required hospitalization three to four times each year while on maximal medical therapy for heart failure.
The Patient came to MMHRC with severe heart failure. After seen her heart condition, doctors decided to perform Left bundle branch pacing–optimized implantable cardioverter-defibrillator (LOT-ICD) for potential Cardiac resynchronization therapy (CRT) implant to wide QRS with Left bundle branch block (LBBB) morphology.
Talking about the condition, Dr. S. Selvamani, Senior Consultant, Department of Cardiology, MMHRC said, “LBBP is a challenging as we need to add a defibrillator to these patients as they have significant LV dysfunction and makes sure that they are prevented from sudden cardiac arrest (SCA). The patient underwent Stellet Driven LOT ICD. The patient was scheduled for CRT since it performs well with LBBP.”
“Instead of using the conventional transvenous LV lead via the coronary sinus, we explored directly stimulating the left ventricular in this instance. By eliminating a very prolonged procedure, we could achieve similar or better results with less hardware. She received a modified Dual Chamber ICD (LOT-ICD-Left Ventricular Optimized -ICD) since her QRS narrowed without the addition of the LV lead. The procedure helped in desynchronizing the heart without the addition of an LV lead by directly stimulating the LV through the condition system. A specialized deflectable catheter made for condition system pacing with conventional pacing leads, was used for the procedure. Coronary Sinus (CS) lead was not placed and the procedure was stopped” added Dr. S. Selvamani.
Dr. B. Kannan, Medical Administrator, MMHRC said, “The majority of patients who can benefit from our advanced therapy are not aware of the facilities available in Tamil Nadu. Our goal is to provide the highest quality of patient-centered care to many more patients in Tamil Nadu, utilizing our interdisciplinary approach and the multi-skilled resources within our team.”
The event-less procedure, done under local anesthesia, took around two hours to complete. The patient was discharged 2 days after the procedure and resumed all normal activities. The meticulous treatment plan devised by a multidisciplinary team achieved superior results for the patient. The Cardiology team members were also present during the press meet.
