Trifascicular Block CRTD Pacemaker Implantation

Sample Opinion // Trifascicular Block// CRTD // Pacemaker Implantation // Presyncope

Diagnosis:

Based on the shared reports, the patient has a Tri fascicular Block and is experiencing symptoms such as dizziness, and presyncope. 

Tri fascicular Block is a dangerous cardiac conduction disorder involving impairment in all three fascicles of the heart’s ventricular conduction system. It is often presented on ECG as a BI fascicular block combined with a first-degree AV block (prolonged PR interval). It is a precursor to complete heart block and requires immediate evaluation, often needing a permanent pacemaker.

Presyncope means feeling as though you may faint or pass out without losing consciousness. It usually occurs when blood flow to the brain temporarily decreases.

We will need to do some investigations to confirm the diagnosis.

Investigations needed: 

Patient will require comprehensive investigations which include ECHO, ECG, Coronary Angiography, Holter, MRI/ Chest x-ray, blood tests, and some other routine tests.

Possible Line of Treatment:

The definitive treatment plan will be decided once the patient arrives, and all his investigation outcomes are thoroughly reviewed by the doctors. However, it is likely that patient will require CRTD with Biventricular Pacemaker Implantation.

A CRT-D (Cardiac Resynchronization Therapy with Defibrillator) is an implanted medical device for advanced heart conditions, combining a Biventricular Pacemaker and an Implantable Cardioverter Defibrillator (ICD). Permanent pacemaker implantation is generally required for true Tri fascicular block to prevent sudden death due to high risk of complete heart block. It is considered a lifesaving, necessary intervention.

Kindly Note: The advised plan is solely based on the reports shared with us. The final line of treatment will be decided post the physical and clinical evaluations of the patient on arrival only.

We will recommend the following Doctors and Hospitals for the patient:

1. Amrita Hospitals // Dr. Sameer Bhate  

2.  Fortis Healthcare Limited-Gurgaon // Dr. (Col) Manjinder Sandhu 

3. Artemis Hospital, Gurgaon // Dr. Amit Kumar Chaurasia  

4. BLK-MAX Super Specialty Hospital // Dr. Subhash Chandra  

5. Sarvodaya Healthcare, Faridabad // Dr. Jay Relan 

Estimated cost:

The estimated cost of evaluations will be approx. USD 800-900 on OPD basis.

The Estimated cost of CRTD with Biventricular Pacemaker Implantation at the various hospital will be approx.: 

Stay in India: The patient will require 2-3 days for initial evaluations on an OPD basis. The patient will require a total of 2-3 days of hospitalization for the procedure. The post-discharge of the patient may require 15 days to follow up on an OPD basis. Total Length Stay in India will be approx. 2-3 weeks.

Inclusions:

1.  The cost of all investigations related to the procedure.
2. The cost of the treatment.
3. The doctor’s fee and surgery charges.
4. Domestic Indian stents will be used. 
5. The stay of the patient and 1 attendant during hospital admission.
6. All meals for the patient and the attendant as per the available menu while in hospital.
7. Medical Consumables and Medicines while in hospital.
8. The fee for dietician and nursing while in hospital.
9. It also includes complimentary Airport Transfers, Forex Services, and assistance.

Exclusions:

1.  Any consultation other than in discussion
2. Extended stay.

On Arrival: 

The patient and her attendant will be received at the airport by our Representative. Apart from the medical and nursing team, one Case Manager will take care of all the needs. We shall also assist them with reasonably charged accommodation near the hospital. They may prepare USD 30-50 per day towards accommodation in the guest house after being discharged from the hospital.

Hope I have been able to give you a satisfactory answer to the query. Do kindly ask for any clarifications needed. I will be happy to answer & shall look forward to assisting your patient in India.

Regards,

Dr. Anmol