Kenyan doctors have successfully conducted the first leadless pacemaker procedure in Sub-Saharan Africa, expanding treatment options for patients with heart rhythm disorders.
- •Unlike conventional pacemakers, which require a surgical incision in the upper chest and electrical wires (leads) inserted through veins into the heart, leadless pacemakers are miniature capsule-sized devices delivered directly into the heart through a catheter inserted via a vein in the leg.
- •The pacemaker, in this case the latest-generation Micra AV2 leadless pacemaker, lives entirely within the heart, eliminating the need for a surgical pocket or transvenous leads.
- •The procedure was performed by a multidisciplinary cardiac team led by Dr Mohamed Jeilan, Head of Cardiology at Aga Khan University Hospital (AKUH).
Experts recommend leadless pacemakers in specific situations where they may offer advantages over conventional devices. The first patient had severe obstruction of the central veins normally used to insert pacemaker leads, related to long-term dialysis access and prior radiotherapy treatment, a combination that made conventional device placement difficult and high risk.
“Leadless pacing provided an ideal solution for this patient,” said Dr. Jeilan. “In cases where veins are blocked or access is compromised, this technology allows us to deliver effective therapy without the need for surgical pockets or transvenous leads.”
Leadless pacemakers are roughly the size of a large tablet and are implanted inside the heart during a minimally invasive procedure that typically lasts under an hour. Because the device sits entirely within the heart and does not use leads, it reduces infection risk and long-term mechanical complications, two important concerns in regions where managing device complications can be challenging.
“Increasingly, patients in our region are able to access cutting-edge technologies in heart care, something which contrasts with previous decades where most patients were unable to access advanced cardiac treatments,” Dr. Mzee Ngunga, President of the Kenya Cardiac Society, said. “Introducing leadless pacing demonstrates that we continue to provide world-class, cutting-edge care locally.”
Aga Khan University Hospital has introduced several minimally invasive cardiac technologies to Kenya over the past two decades, including coronary physiology (FFR) in 2006, rotational atherectomy in 2013, renal denervation for hypertension in 2013, and transcatheter aortic valve replacement in 2015. In 2017, the hospital also launched the country’s first cardiology specialisation training programme.
