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Sir, I am very serious Cardio patatient my Three Artary blocked 95% my ejection fraction. 35% now my pulse rate 45 . At this position dr. Advice PERMANENT PACEMAKER IMPLANATION DUE to my problem as AV synchrony can be maintained in dual chamberPPI. Now RTIICS approximate estimated cost Rs.1,65,642=00. But your prior permisdion requird before implanation. I am very hopeless withing 26-02-2014 pacemaker implantation urgent due to my health condition. I will submitt all relevant paper through proper chanel on 23-02_2014 at berhampur irrigation division, murshidabad. I pray to you if iwill go to your department with all relevant paper and a advance copy of my prayer if you arrange me prior permission for save my life.i am waiting for your kind feef back as early as possiable.