Analysis of a five year experience of permanent pacemaker implantation at a Nigerian Teaching Hospital: need for a national database

Falase, Bode; Sanusi, Michael; Johnson, Adeyemi; Akinrinlola, Fola; Ajayi, Reina; Oke, David Mautin

doi:10.11604/pamj.2013.16.16.2644

Cited by 10 publications

(21 citation statements)

References 18 publications

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“…There are few reported series on pacemaker implantation in Nigeria. This is a slowly evolving practice, mainly due to the cost of pacemaker implantation (14) and limited expertise (15). Both single and dual chamber implantation is performed.…”

Section: Discussionmentioning

confidence: 99%

The challenges of cardiothoracic surgery practice in Nigeria: a 12 years institutional experience

Falase

Sanusi

Animasahun

et al. 2016

Cardiovasc. Diagn. Ther.

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Infections, malignancy and trauma currently account for the bulk of cardiothoracic surgery practice in Nigeria, with surgical activity showing a predominance of minor procedures and comparatively minimal OHS activities. Identified challenges to increasing cardiothoracic surgical activity were limitations in manpower development, infrastructure, laboratory support, local availability of consumables, cost of surgery, funding mechanisms for surgery, multiple models for development of cardiac surgery, decentralization of efforts and lack of outcome data. Data collection and reporting of results must be started to enable development of more evidence-based practice.

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Section: Discussionmentioning

confidence: 99%

The challenges of cardiothoracic surgery practice in Nigeria: a 12 years institutional experience

Falase

Sanusi

Animasahun

et al. 2016

Cardiovasc. Diagn. Ther.

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“…Seventeen studies on bradyarrhythmias and CIEDs in SSA were identified through the systematic search [9,11,12,[105][106][107][108][109][110][111][112][113][114][115][116][117][118][119] (Figure 1). Table 4 depicts 13 of these studies with some uniform data that could be organized into one table.…”

Section: Indications Of Device Implantation Type Of Devicementioning

confidence: 99%

“…The commonest indication for permanent pacing in SSA is atrioventricular block (AVB) accounting for 45-100% of all cases across studies, compared to sick sinus syndrome at 0-35%, and others (atrioventricular node ablation, cardiac re-synchronization therapy, etc) 0-20%. Single chamber ventricular (VVI) pacemakers are the most frequently implanted (17-87%), compared to dual chamber (12-82%), and others like atrial-sensed ventricular-paced (VDD) (0-15%) [107][108][109][110][111][112][113][114][115][116][117]120]. Cost constraints have been identified as the reason for high implant percentage of VVI compared to DDD [114].…”

Section: Indications Of Device Implantation Type Of Devicementioning

confidence: 99%

“…In a study with long-term survival data after permanent pacing in SSA, there was a 17% mortality after a median follow-up time of about nine years [115]. Complications of pacing across studies are infections (0-6%), lead displacements (0-6%), pneumothorax (0-1.5%), hemothorax (0-1.5%), erosions (0-5.3%%), and death (0-2%) [107][108][109][110][111][112][113][114][115]120].…”

Section: Implantation Rates Of Pacemakers and Defibrillators Plus Commentioning

confidence: 99%

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A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Yuyun

Bonny

et al. 2020

Global Heart

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Major structural cardiovascular diseases are associated with cardiac arrhythmias, but their full spectrum remains unknown in sub-Saharan Africa (SSA), which we addressed in this systematic review. Atrial fibrillation/atrial flutter (AF/AFL) prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, but <1% in the general population. Use of oral anticoagulation is heterogenous (9-79%) across SSA. The epidemiology of sudden cardiac arrest/death is less characterized in SSA. Cardiopulmonary resuscitation is challenging, owing to low awareness and lack of equipment for life-support. About 18% of SSA countries have no cardiac implantable electronic devices services, leaving hundreds of millions of people without any access to treatment for advanced bradyarrhythmias, and implant rates are more than 200-fold lower than in the western world. Management of tachyarrhythmias is largely noninvasive (about 80% AF/AFL via rate-controlled strategy only), as electrophysiological study and catheter ablation centers are almost non-existent in most countries. Highlights:-Atrial fibrillation/flutter prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, and <1% in the general population in sub-Saharan Africa (SSA).-Rates of oral anticoagulation use for CHA2DS2VASC score ≥2 are very diverse (9-79%) across SSA countries.-Data on sudden cardiac arrest are scant in SSA with low cardiopulmonary resuscitation awareness.-Low rates of cardiac implantable electronic devices insertions and rarity of invasive arrhythmia treatment centers are seen in SSA, relative to the high-income countries.

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“…Bradyarrythmias are a cause of sudden death everywhere in the world, although the precise incidence is unknown. Pacemaker implantation is an accepted intervention which has been shown to improve the quality of life and reduce mortality in patients with bradyarrythmias (Falase et al, 2013). Kashmir valley is inhabited by a relatively homogenous inbreeding population with dietary practices and living conditions that do not differ significantly across the valley.…”

Section: Discussionmentioning

confidence: 99%

Decade of permanent cardiac pacing in a tertiary care hospital of Northern India

Lone¹,

Naiku²,

Din³

2016

Int. J. Med. Med. Sci.

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This study of 10 year review of pacing was undertaken to analyse the continuous rise in the incidence of pacing in this part of country. 532 patients implanted with permanent pacemakers were evaluated during this decade. The age of patients ranged from 6 to 85 years with majority of patients belonging to age group of 55 to 70 years and a male to female ratio of 2:1. The commonest presenting symptom was cardiac syncope seen in 76.50% followed by pre-syncope 31.50% .The indications for pacemaker implantation were complete heart block 48.12%, sick sinus syndrome 19.17%, symptomatic bifascicular block 12.96%, Mobitz type II 2 nd degree heart block 7.14%, permanent pacemaker dysfunction 5.85%, trifascicular block 5.63% and high degree AV block 1.13%. The commonest risk factors encountered in these patients were smoking 59.21%, followed by hypertension 26.32%, only 0.56% had no evidence of risk factor. The complications following pacemaker implantation were seen in 8.27%, 2.26% got lead displacement, 1.69% got wound infection, 1.69% got extrusion of generator. Other complications include lead fracture in 0.9%, premature battery failure 0.37% patients, high threshold in 0.19%, Pneumothorax in 0.19% and 0.5% got reimplantation because of generator expiry. Out of 532 patients paced permanently in the past decade, 458 patients followed regularly which revealed that majority of them were totally dependent upon the permanent pacemaker and had improved quality of Life.

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Analysis of a five year experience of permanent pacemaker implantation at a Nigerian Teaching Hospital: need for a national database

Cited by 10 publications

References 18 publications

The challenges of cardiothoracic surgery practice in Nigeria: a 12 years institutional experience

The challenges of cardiothoracic surgery practice in Nigeria: a 12 years institutional experience

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Decade of permanent cardiac pacing in a tertiary care hospital of Northern India

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