Hyderabad-based KIMS (Krishna Institute of Medical Sciences) has performed a unique kind robotic procedure to treat cardiac arrest for the first time in the country.

A team of doctors at KIMS had performed a robotic procedure combined with three dimensional mapping and ablation to treat a life threatening complex arrhythmia for the first time in the country. To treat such complexities a high degree of skills is required as the mortality rate in such cases is very high.

According to B Hygriv Rao, chief of electrophysiology and pacing, a 59-year old patient suffering from a life threatening arrhythmia termed VT Storm was admitted in KIMS for cardiac treatment.

The patient who is from Maharashtra had a history of heart attacks and few months ago developed a ventricular tachycardia (VT) which is a life threatening rhythm of the heart leading to cardiac arrest. The patient had also undergone an ICD implantation which is the routine treatment in these cases. ICD is given to such patients to protect them from sudden death. In addition he was also taking medication to suppress VT. Generally such patients have VT twice or thrice a year on the average which would be terminated by shocks.

As per the patient’s case history, in early November 2013, this patient had under gone15-20 episodes of ventricular tachycardia, all of them requiring shocks. The doctors performed device interrogation. It showed showed positive results and the device function was normal. To control the VT episodes the doctors put the patient on ventilator and multiple medications administered by vein; even then it was not helpful.

"After trying all methods we finally decided to devise a new treatment strategy where we would disconnect the sympathetic nerves to heart followed by radiofrequency ablation. The denervation procedure was done using a robot by the Oncosurgeon. Robot was used for precision, and completeness," said Dr B Hygriv Rao, the chief of electrophysiology and pacing.

After the robotic procedures the doctors used a 3D mapping system and carefully cleaned up an old clot in the left ventricle of the heart, the chamber from where the VT was arising. Dr Hygriv Rao successfully performed the radiofrequency ablation carefully and meticulously identifying abnormal areas and destroying them. The procedure took about five hours. After the ablation, patient did not have any VT and has been discharged and is performing well without any episodes of VT even after six weeks of the surgery.

The treatment was conducted by a team led by Dr B Hygriv Rao. The other members of the team were Oncosurgeon Dr Jagdishwar Gowd, Senior interventional cardiologist Dr PA Jiwani, Dr Naresh, chief of anaesthesia, cardiologists Dr Pushpa Raj and Dr Kaustub.