Newborn receives pacemaker at ICH

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First in government sector in the State, say doctors

A baby, less than a month old, has received a pacemaker for a complete congenital heart block at the Institute of Child Health (ICH) and Hospital for Children. Doctors say this is the first neonate to get a pacemaker implanted by a public sector hospital in the State.
It was during the eighth month of pregnancy that Kasturi, 27, a resident of Harur, was told that the foetus had a low heart rate. The next few weeks were filled with anxious moments for Kasturi and her husband, Kuppusamy, an agricultural labourer, as they waited for the birth of their second child.
“Doctors told us it was better to wait and watch how the baby comes through with the low heart rate. But he cried as soon as he was born like a normal newborn, was active and feeding well. However, his heart rate continued to be low,” the mother said. Delivered through a caesarean section on December 25 at a private hospital in Harur, the baby weighed 2.8 kg at birth. His heart rate was 50 beats per minute as against the normal heart rate for a newborn, doctors said. The baby was referred to the Government Mohan Kumaramangalam Medical College and Hospital, Salem, and subsequently sent to ICH.
“A newborn should have a heart rate of 120-140 for effective pumping of blood to organs and to promote growth. This baby had 50 beats per minute. The low heart rate was due to a heart block. The transmission of signals that affect heart beats was absent due to poor development of the conduction system,” Dr. A.T. Arasar Seeralar, director of ICH, said.
A team of doctors headed by G.K. Jaikaran, head, Paediatric Cardiothoracic Surgery, ICH performed the surgery on January 12. “An epicardial pacemaker was implanted inside the chest wall and the heart rate was fixed at 120/minute,” Dr. Jaikaran said. The procedure was covered under the Chief Minister’s Comprehensive Health Insurance Scheme, he added.

A permanent solution

Doctors said the baby would require a revision of the pacemaker after eight to 10 years. C.N. Kamalarathnam, professor and head, Neonatology, ICH, said they initially suspected that the mother could have an autoimmune disease, Systemic Lupus Erythematosus (SLE), that usually caused such an anomaly in the baby.
“But she did not suffer from SLE. The baby had normal heart structure with a heart rate that remained less than 55/minute. This was an important indicator for implanting a pacemaker. Medical management could act as a stop-gap measure but the baby required a permanent solution,” he explained.
The baby is receiving mother’s milk through a tube and will be on direct feed soon, he added. Dr. Seeralar added that in the last one decade, ICH had come across seven babies with heart blocks. Six did not survive, while one of them received a pacemaker at a private hospital in the city, he added.

Source: https://www.thehindu.com/news/cities/chennai/newborn-receives-pacemaker-at-ich/article26039556.ece

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