Specialists at Aga Khan University Hospital (AKUH) have successfully implanted a leadless pacemaker for the first time in sub-Saharan Africa, marking a major milestone that is set to expand treatment options for patients with heart rhythm disorders across the region.
The groundbreaking procedure was performed by a multidisciplinary cardiac team led by Dr Mohamed Jeilan, Head of Cardiology at AKUH, placing the hospital among a select group of global centres offering this next-generation technology.
Unlike conventional pacemakers, which require a surgical incision in the upper chest and the insertion of electrical wires (leads) through veins into the heart, leadless pacemakers are miniature, capsule-sized devices delivered directly into the heart via a catheter inserted through a vein in the leg.
The device resides entirely within the heart, eliminating the need for a surgical pocket or transvenous leads.The first patient treated at AKUH required this advanced approach because traditional pacemaker implantation was not feasible.
The patient had severe obstruction of the central veins typically used for pacemaker lead placement, a complication linked to long-term dialysis access and prior radiotherapy.
This combination made conventional device implantation both 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.”
According to a statement from Aga Khan, the device used was the latest-generation Micra AV2 leadless pacemaker.
This advanced system is capable of coordinating electrical activity between heart chambers in selected patients, significantly expanding the number of individuals who can benefit from leadless technology compared to earlier versions.
Leadless pacemakers, roughly the size of a large vitamin capsule, are implanted during a minimally invasive procedure that typically takes less than an hour.
Experts note that pacemakers remain among the most impactful treatments in modern medicine, with rapid technological advancements transforming patient care in recent years.
Dr Mzee Ngunga, a member of the procedural team, described the development as a significant step forward for cardiac care in the region.
“Increasingly, patients in our region can access cutting-edge technologies in heart care, something that contrasts sharply with previous decades, when advanced cardiac treatments were largely out of reach,” he said.
“Introducing leadless pacing demonstrates our continued commitment to delivering world-class, innovative care locally.”
Leadless pacemakers are particularly recommended in specific clinical situations where they offer clear advantages over conventional devices.
These include patients with blocked veins, individuals on long-term dialysis, those at high risk of infection, and patients who have previously experienced device-related infections.
Because the device is fully self-contained within the heart and does not rely on leads, it significantly reduces the risk of infection and long-term mechanical complications, two critical concerns in settings where managing such complications can be challenging. URN