Specialists at Aga Khan University Hospital (AKUH) have successfully implanted a leadless pacemaker for the first time in sub-Saharan Africa, a milestone expected to expand treatment options for patients with heart rhythm disorders across the region.
The procedure was performed by a multidisciplinary cardiac team led by Dr Mohamed Jeilan, Head of Cardiology at AKUH, positioning the hospital among a select group of centres globally offering this next-generation technology.
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 lives 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 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.”
The device used was the latest-generation Micra AV2 leadless pacemaker, which can coordinate electrical activity between heart chambers in selected patients, expanding the number of individuals who can benefit from leadless technology compared with earlier systems.
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.
Pacemakers are among the most impactful treatment options available in medical science, and the technology has evolved dramatically over recent years.
Dr Mzee Ngunga, President of the Kenya Cardiac Society, who was also part of the procedural team, described the development as a major step forward for cardiac care in the country.
“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,” he said. “Introducing leadless pacing demonstrates that we continue to provide world-class, cutting-edge care locally.”
Experts recommend leadless pacemakers in specific situations where they may offer advantages over conventional devices. These include patients with blocked veins, those on long-term dialysis, individuals with a high risk of infection, and patients who have previously experienced device infections.
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.
Medtronic, the manufacturer of the Micra system, said the introduction reflects confidence in the hospital’s expertise and regional leadership.
“We are committed to expanding access to innovative cardiac technologies globally. Aga Khan University Hospital has demonstrated strong clinical capability, infrastructure, and commitment to advancing cardiovascular care, making it an important centre for the introduction of leadless pacing in the region.” a Medtronic Spokesperson said.
Experts also note that the use of leadless pacemakers is expanding as technology advances, with future systems expected to treat more complex rhythm disorders and potentially heart failure conditions without traditional wires.
The achievement builds on a long tradition of pioneering cardiovascular innovation at Aga Khan University Hospital, which 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.
Healthcare leaders say the milestone reinforces Kenya’s growing reputation as a regional hub for specialised medical care.
“Our goal is not only to treat patients, but to build capacity. We want to train African cardiologists, expand access to modern therapies, and reduce the need for patients to travel abroad for treatment. This achievement demonstrates that, with the right expertise and institutional commitment, highly specialised therapies can be delivered locally,” said Dr Jeilan.
Cardiovascular disease is rising rapidly across the continent, and specialists believe innovations such as leadless pacing will play a significant role in strengthening cardiac care systems in the years ahead.
