Younten Tshedup 

The country’s first independent pacemaker implantation surgery was successfully conducted on a 54-year-old woman at the national referral hospital on July 1.

The patient was referred from Mongar with a complete heart block condition (low heart rate) resulting in loss of consciousness. The intervention was to increase her heart rate by inserting a pacemaker.

The surgery involves implanting a small electrical device (pacemaker) about the size of a matchbox or smaller in the patient’s chest, below the collarbone.

The pacemaker sends electrical impulses to the heart through wires to keep it beating regularly or not too slowly.

Earlier patients requiring pacemaker implants were sent to India. However, due to the current pandemic, referrals abroad were difficult.

In 2018, a pacemaker implantation surgery was conducted at the national referral hospital. The surgery was performed under the supervision of a foreign doctor then.

This time, a cardiologist who had returned mid-way from pursuing his sub-specialisation in interventional cardiology in Thailand due to the Covid-19 pandemic, decided to lead the surgery.

Cardiologist with the national referral hospital Dr Mahesh Gurung said that the procedure went well and he was confident of the surgery given his experience in Thailand.

“The successful procedure was a team effort. The patient is in a stable condition. She is happy that the procedure could be done within the country.”

Besides the cost of the machine, which is about Nu 180,000, the government spent over Nu 150,000 on each patient sent for a pacemaker implantation abroad.

JDWNRH’s medical superintendent Dr Gosar Pemba said that providing such services on a full time basis in the country would save the government on referral costs.

He said that of the many specialised services planned in the 12th Plan, the pacemaker implantation programme was one.

Dr Gosar Pemba said that with the rise in sedentary lifestyle among the people and unhealthy diet, there is an increasing case of coronary heart diseases in the country.

In preparation to address these issues, he said that the national referral hospital also plans to establish a Cath lab. The lab would be used to visualise the arteries and chambers of the heart and treat any stenosis or abnormality found using diagnostic imaging equipment.

However, with the current pandemic the medical superintendent said that the projects that were supposed to complete by June next year could be further extended. The funding support from the government for the activities is also in question now.

Dr Mahesh Gurung said that once the Cath lab is established and the staff trained, service delivery to the public would improve. Besides being cost-effective for the government, he said that resources would be better used and ultimately the patients would be benefitted.

Meanwhile, other specialised services planned by the national referral hospital in the 12th Plan include kidney transplant, mammography, joint replacement, dental implantation, cochlear implant, and a sleep study programme.