In a rarest of rare case and a groundbreaking medical achievement, Medica Superspecialty Hospital, part of the Manipal Hospitals group, achieved a momentous feat by successfully implanting a Micra leadless pacemaker in a 33-year-old woman suffering from a complex congenital heart disease, tetralogy of Fallot (obstruction in the pulmonary valve leading from the right ventricle to the lung artery preventing the normal amount of blood from being pumped to the lungs). The patient, RM (name changed), from Barrackpore and her family comes from a very humble background, who did not have the means to undergo this nature of surgery. Thus unfolded a story of medical innovation, teamwork, and the power of community support by few noble souls from the society and above all Manipal Foundation, the social and the philanthropic arm of the Manipal Education and Medical Group (MEMG). The procedure was led by Dr. Dilip Kumar, Director of the Cardiac Cath Lab & Senior Consultant Interventional Cardiologist & Electrophysiologist, Medica Superspecialty Hospital (a part of Manipal Hospitals Group), Dr. Anil Kumar Singhi, Head – Paediatric Cardiology & Senior Interventional Cardiologist and Dr. Somnath Dey, Cardiac Anaesthesiologist. They were joined by Dr. Prakash Kumar Hazra, Director and Head Cardiology Specialist, Manipal Hospital Dhakuria during a briefing session with the patient today, marking this as the first known case of such a procedure in this rare and challenging anatomy.
Since birth, the patient, RM (Name changed) was detected with tetralogy of Fallot (TOF) had previously undergone intracardiac repair and bilateral Glenn shunt (a palliative surgical procedure used in children with cyanotic congenital heart disease) connecting the superior vena cava (SVC) – a large vein that carries deoxygenated blood from the head, neck, arms, and chest to the pulmonary artery to enhance pulmonary blood flow. She had a failed epicardial pacing lead (a situation where the lead, which delivers electrical impulses to the heart, malfunctions, requiring replacement or abandonment). Due to this structural alteration, conventional transvenous pacemaker placement (procedures or devices that involve entering or passing through a vein) was not viable. Since her tetralogy of Fallot operation the patient required a pacemaker as she developed complete heart blockage after her operation and received an epicardial pacemaker with the pulse generator placed in the abdominal region. However, epicardial leads have a higher failure rate, and by 2015, she required a battery replacement. At that time, due to financial constraints and technological limitations, her existing leads were retained despite high pacing thresholds.
By 2024, the leads had completely failed, leaving the patient dependent on a temporary pacemaker. Given her complex cardiovascular anatomy and the absence of viable venous access for a traditional pacemaker, a leadless pacemaker was the only feasible solution. However, this presented both financial and technical challenges. She was admitted under the care of Dr. Dilip Kumar at Medica on 3rd March 2025 and her post procedure stay was uneventful. She was discharged on 5th March 2025 in haemodynamically stable condition.
Elaborating on this challenging yet miraculous feat, Dr. Dilip Kumar stated, “To our knowledge, there is no documented case of a leadless pacemaker implantation in a patient with Tetralogy of Fallot repair and Glenn shunt. This achievement opens new possibilities for similar high-risk cases worldwide. We are in the process of submitting the paper in a US journal. The success of this procedure highlights the advancements in advanced cardiac care available at our hospital and showcases the importance of financial aid programs in ensuring life-saving treatments reach those in need. It was truly heartwarming to see the patient’s smiling face and the relief of a mother caring for her 3-year-old child. Grateful to Dr. Singhi for his valuable contribution from the paediatric cardiology team and to everyone involved in making this possible.”
The patient RM stated, “I do not have enough words to thank Dr. Dilip Kumar and the entire team at Medica Hospital. For years, I lived in fear, knowing my heart was failing and that my family had no means to afford the treatment I needed. But Dr. Kumar never gave up on me. He always gave me hope and found a way to make the impossible happen. I am thankful to Manipal Foundation, various NGOs, and individuals who have come forward to support my family. Now, I am back home to my little child, knowing I have a long future ahead.”
Dr. Vasudha Shetty, Senior Director- Business Operations Manipal Hospitals – CSR, Manipal Health Enterprises Pvt. Ltd. commented on the impact of theManipal Foundation’s support, “At Manipal Foundation, we are committed to ensuring that critical healthcare reaches those who need it the most, irrespective of financial constraints. This case is a testament to how corporate social responsibility (CSR) initiatives can transform lives. By mobilizing resources and uniting the generosity of donors, we were able to provide this young mother with a second chance at life. It is moments like these that reinforce our mission to bridge the gap in healthcare accessibility and bring hope to families in distress.”
Dr. Ayanabh Debgupta, Regional Chief Operating Officer, Manipal Hospitals (East), shared, “Our mission at Manipal Hospitals has always been to bring the best medical & technological advancements to the eastern region so that patients can benefit without having to travel to other parts of the country. This complex procedure demanded precision and care, and our cardiology teams across all Manipal Hospitals, go above and beyond to provide comprehensive guidance, preparing patients both mentally and physically to ensure the best possible outcomes and recovery. As a responsible caregiver Manipal Hospitals together with Manipal Foundation has proven that humanity comes first, and we aspire to set many more such examples in future. Manipal Foundation’s intervention has been instrumental in saving the patient’s life, ensuring access to this groundbreaking procedure. On behalf of the team, I appreciate those noble citizens whose gestures of kindness in times of need demonstrated the power of collective goodwill. This case will set an example around the importance of advanced medical interventions besides highlighting how community-driven efforts can change lives.”
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