Statistics on the use of cardiac electronic devices and interventional electrophysiological procedures in Africa from 2011 to 2016: report of the Pan African Society of Cardiology (PASCAR) Cardiac Arrhythmias and Pacing Task Forces

被引：35

作者：

Bonny, Aime ^{[1
,2
,3
]}

Ngantcha, Marcus ^{[2
]}

Jeilan, Mohamed ^{[4
]}

Okello, Emmy ^{[5
]}

Kaviraj, Bundhoo ^{[6
]}

Talle, Mohammed A. ^{[7
]}

Nel, George ^{[8
]}

Marijon, Eloi ^{[9
,10
]}

Sani, Mahmoud U. ^{[11
]}

Yousef, Zaheer ^{[12
]}

Karaye, Kamilu M. ^{[11
]}

Toure, Ibrahim A. ^{[13
]}

Awad, Mohamed A. ^{[14
]}

Millogo, George ^{[15
]}

Kologo, Jonas ^{[15
]}

Kane, Adama ^{[16
]}

Houndolo, Romain ^{[16
]}

Dzudie, Anastase ^{[17
]}

Mbakwem, Amam ^{[18
,19
]}

Mayosi, Bongani M. ^{[20
]}

Chin, Ashley ^{[21
,22
]}

机构：

[1] Univ Douala, Cardiac Unit, Univ Hosp Laquintinie, 4035 BP, Douala, Cameroon

[2] Cameroon Cardiovasc Res Network, 15523 BP, Douala, Cameroon

[3] Ctr Hosp V Dupouy, Serv Cardiol, 69 Rue Lt Col Prudhon, F-95107 Argenteuil, France

[4] Aga Khan Univ Hosp, Dept Med, 3rd Parklands Rd, Nairobi, Kenya

[5] Makerere Univ, Uganda Heart Inst, Dept Cardiol, Mulago Hosp Complex,Mulago Hill Rd,POB 7051, Kampala, Uganda

[6] Dr AG Jeetoo Hosp, Dept Cardiol, Port Louis, Mauritius

[7] Maiduguri Teaching Univ Hosp, Dept Cardiol, Maiduguri, Nigeria

[8] Univ Cape Town, Dept Med, Pan African Soc Cardiol PASCAR, ZA-7925 Cape Town, South Africa

[9] Hop Europeen Georges Pompidou, Dept Cardiol, 20 Rue Leblanc, F-75908 Paris, France

[10] INSERM, Global Hlth Unit, U970, 20 Rue Leblanc, F-75908 Paris, France

[11] Bayero Univ, Aminu Kano Teaching Hosp, Dept Med, Kano 700223, Nigeria

[12] Univ Hosp Wales, Dept Cardiol, Cardiff CF14 4XW, S Glam, Wales

[13] Ctr Hosp Lamorde, Serv Med Interne & Cardiol, POB 13220, Niamey, Niger

[14] Univ Khartoum, Dept Med, Elgaasr St,POB 111, Khartoum, Sudan

[15] Ctr Hosp Yalgado Ouedraogo, Serv Cardiol, Ouagadougou, Burkina Faso

[16] CHU Aristide Dantec, Serv Cardiol, Dakar, Senegal

[17] Douala Gen Hosp, Dept Internal Med, 2549 BP, Douala, Cameroon

[18] Univ Lagos, 12003 PMB, Lagos, Nigeria

[19] Lagos Univ Teaching Hosp, Coll Med, Dept Med, 12003 PMB, Lagos, Nigeria

[20] Univ Cape Town, Fac Hlth Sci, Deans Off, Barnard Fuller Bldg,Anzio Rd, ZA-7925 Cape Town, South Africa

[21] Groote Schuur Hosp, Cape Town, South Africa

[22] Univ Cape Town, Cardiac Clin, Dept Med, Main Rd, Cape Town, South Africa

来源：

EUROPACE | 2018年 / 20卷 / 09期

关键词：

Pacemaker; Cardiac resynchronization therapy; Implantable cardioverter-defibrillator; Cardiac electrophysiology; Africa; Interventional electrophysiological procedures; Catheter ablation; ATRIOVENTRICULAR-BLOCK; PACEMAKERS;

D O I：

10.1093/europace/eux353

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims To provide comprehensive information on the access and use of cardiac implantable electronic devices (CIED) and catheter ablation procedures in Africa. Methods and results The Pan-African Society of Cardiology (PASCAR) collected data on invasive management of cardiac arrhythmias from 2011 to 2016 from 31 African countries. A specific template was completed by physicians, and additional information obtained from industry. Information on health care systems, demographics, economics, procedure rates, and specific training programs was collected. Considerable heterogeneity in the access to arrhythmia care was observed across Africa. Eight of the 31 countries surveyed (26%) did not perform pacemaker implantations. The median pacemaker implantation rate was 2.66 per million population per country (range: 0.14-233 per million population). Implantable cardioverter-defibrillator and cardiac resynchronization therapy were performed in 12/31 (39%) and 15/31 (48%) countries respectively, mostly by visiting teams. Electrophysiological studies, including complex catheter ablations were performed in all countries from Maghreb, but only one sub-Saharan African country South Africa). Marked variation in cost (up to 1000-fold) was observed across countries with an inverse correlation between implant rates and the procedure fees standardized to the gross domestic product per capita. Lack of economic resources and facilities, high cost of procedures, deficiency of trained physicians, and non-existent fellowship programs were the main drivers of under-utilization of interventional cardiac arrhythmia care. Conclusion There is limited access to CIED and ablation procedures in Africa. A quarter of countries did not have pacemaker implantation services, and catheter ablations were only available in one country in sub-Saharan Africa.

引用

页码：1513 / 1526

页数：14

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