The governor of the Northern Marianas, Eloy Inos, will be off work for the rest of the year to recover from open-heart surgery in the United States.
Mr Inos is still under close observation and in intensive care.
His office says the recovery process will require Mr Inos to undergo lengthy therapy and he is not expected to return to the CNMI until late December or early January 2016.
He suffers from diabetes and undergoes dialysis at the Commonwealth Health Center three times a week.
Last January, Mr Inos was confined to the hospital due to symptoms of pneumonia.
In November 2014, he disclosed that his medical leave to Manila that month was for a follow-up to a bypass heart surgery he had in 2006.