AF is the most common arrhythmia globally. The 2010 Global Burden of Disease (GBD) data estimated the global burden of AF at 33.5 million (3). In HICs, such as the United States, AF affects 2-6 million people currently and it is expected to double by 2060 (4,5). The prevalence Review Article on Cardiovascular Diseases in Low-and Middle-Income Countries

HIV/AIDS is a major public health burden, with an estimated 35.3 million people infected globally. [1] Sub-Saharan Africa (SSA) bears the brunt of the pandemic, with 25 million HIV-positive people living in the region. [1] The advent of highly active antiretroviral therapy (HAART) has changed the natural history of HIV/AIDS, with a reported decline in mortality from 24.5 per 100 person-years in 1995 to 8.9 per 100 in 1997, [2] and reportedly 2.1 per 100 in 2010. [3] Today HIV-positive patients in high-income countries are reported to have a life expectancy approaching that of the general population. [4] Despite evidence of the role of HAART in decreasing morbidity and mortality in HIV-positive patients, in resource-poor settings many people living with HIV do not have access to HAART or receive treatment late. Globally, only 9.7 million people were estimated to be receiving HAART in 2012. [5] Many HIV-positive people present with serious illnesses that may require intensive care unit (ICU) admission, [6] and a large proportion of these are unaware of their HIV status. [7] Data from high-income countries suggest that 7 -12% of HIV-positive patients admitted to hospital are treated in the ICU. [8,9] Historically, respiratory failure accounted for the majority of ICU admissions in the HIV-positive patient population, with an associated mortality of ~70%. [9,10] However, contemporary evidence from high-income countries suggests that ICU outcomes are similar to those of HIV-negative patients and that the indications for ICU are mostly not related to opportunistic infections (OIs). [10,11] ICU utilisation and outcomes for HIV-positive patients in poorly resourced settings, where access to both intensive care and HAART is limited, have not been widely studied. With an increasing prevalence of HIV and an unchanging (and at times decreasing) number of available ICU beds, it is imperative to know the profile and outcome of HIV-positive patients requiring ICU admission in a resource-poor setting such as South Africa (SA). ObjectiveTo identify indications for ICU admission and determine factors associated with high ICU and hospital mortality in HIV-positive patients admitted to ICUs in a resource-limited setting. This will help in determining the appropriateness of offering ICU care to HIVpositive patients and in the appropriate development of policies and planning for allocation of limited resources. Methods Study design and patient populationThe study was a retrospective folder review conducted from 1 January 2012 to 31 December 2012 in the medical and surgical ICUs at Groote Schuur Hospital (GSH), Cape Town, SA. GSH is a tertiary hospital affiliated to the University of Cape Town (UCT), and is an 867-bed institution with 16 general medicine and general surgery adult ICU beds (excluding the coronary care unit, the neurosurgical ICU and This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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Aims The spectrum and outcomes of catheter ablation procedures performed in South Africa are unknown, and therefore, the feasibility of interventional electrophysiology in the South African public sector is undetermined. Methods and Results This study was a retrospective review of all patients that underwent invasive electrophysiology procedures and catheter ablation at Groote Schuur Hospital (GSH) and the University of Cape Town Private Academic Hospital (UCTPAH) between 01 January 2013 and 31 December 2020. One thousand one hundred eighty‐six invasive electrophysiology procedures were performed during the study period. Of these were 1102 catheter ablation procedures. There were 76 redo catheter ablation procedures, predominantly for atrial fibrillation (AF), which accounted for 39% (30/76) of the repeat procedures. There were only 0.8% (9/1102) catheter ablation related complications which were mostly access related. Atrial fibrillation accounted for most of the ablation procedures, 28.9% (318/1102); these were mainly performed at UCTPAH than at GSH, 300 vs 18 p < .0001. Cavotricuspid isthmus (CTI) dependent atrial flutter ablation was the second most commonly performed catheter ablation procedure, accounting for 21.6% (238/1102) of the catheter ablation procedures. More CTI dependent atrial flutter ablations were performed at GSH than a UCTPAH, 156 vs 82 p < .0001. The overall success rate of catheter ablation was 92%. Conclusion A broad spectrum of catheter ablation procedures was performed with a high success rate and limited complications, thus demonstrating the feasibility of safe cardiac electrophysiology and catheter ablation in the South African public sector.

This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.