First newborn with permanent pacemaker

Ludhiana, September 22, 2012: A young innocent baby boy was born to Monica and Amit Singh   of Jammu. Unfortunately before birth  they were told that the baby had a complete heart block . In this condition the electrical system of the heart is  underdeveloped  - so that the baby’s heart was beating at 40 beats per minute instead of  the normal of 130 / min. The baby was born in Ludhiana in Iqbal Nursing home in January 2012 .  

Dr Iqbal S Ahuja realised that time was of essence as the condition could be fatal if untreated. He immediately referred the baby to Dr Harinder Singh Bedi – Head of Cardiovascular and Thoracic Surgery at the prestigious Christian Medical College and Hospital in Ludhiana.  

Detailed examination by the Head of Paediatrics –Prof Gurmeet Kaur - confirmed the diagnosis and therapy was immediately instituted.

An immediate permanent pacemaker was inserted in the tiny baby via a minimally invasive approach.

Dr Bedi explained that pacemakers are routinely put in adult patients by the venous route – but in a newborn the veins are too small and so a direct approach to the heart is made by a small incision and the pacemaker is attached to the delicate  heart by a screw-in mechanism.

Dr Bedi has earlier trained at the prestigious Royal Alexandra Hospital for Children in Sydney Australia . His training was put to an extreme test as it took a great deal of skill and finesse to put the dangerous lead on a beating walnut sized tiny heart . Even a 1 mm mistake could have led to a potentially life threatening complication . Speed coupled with caution is required in such cases .

The pacemaker was kept below the skin in a pouch specially created in the abdominal wall . The baby immediately improved.

The other members of the surgical and anesthesia team were Dr A Joseph, Dr Paul, Dr S Garg, Dr Melchi, Dr Udeyana, Dr Marina and Dr Vaishu.

However because of the initial low heart rate the rest of the body was still damaged and took time to recover. The baby was kept in a special ICU called a Paediatric ICU where under the guidance of Dr Gurmeet Kaur highly trained ICU nurses and doctors slowly healed the baby and got her over the crisis.

Dr Gurmeet Kaur said that such newborns need a very specialized environment and trained personnel. CMC is one of the few Institutes in India to have this service.  The other members of the Paediatric team are G Dhar, Dr A Mathew, Dr K Abraham, Dr K Sharma, Dr Tejmeet, and Dr Jaskaran.

The baby is now well and is 8 months old . he has been named Gagandeep Singh . He is a bouncy joy to the parents and doctors . He came to CMC for a checkup and was found to be in excellent health with a well functioning pacemaker.

Dr Bedi told that the pacemaker is a special one which will respond to the metabolic needs of the baby as he grows. A long length of the wire has been left so that it does not pull out with growth. The battery should last 10 – 12 years . The company has a lifelong free battery replacement warranty.

Dr Bedi also said that the battery can be easily changed without disturbing the heart.

Dr Gurmeet Kaur explained that the baby can develop to a normal potential in life and need not be limited in any profession he chooses to follow.

According to the makers of the pacemaker (St Jude - an International company based in USA)  this was the  the first such implantationin a neonate– a newborn baby – in Punjab   in Jan 2012. 

Dr Bedi said that time is of the essence in such cases as a baby cannot live for long at a sub optimal heart rate and a pacemaker is immediately required in such cases . With this surgery a normal life span is expected with an excellent  quality of life .

Dr Abraham G Thomas – Director of CMC& H - reiterated the commitment of CMC & H to deliver the best services for the betterment of people of this region.