Long-term prognosis of patients with permanent cardiac pacemaker indication in three referral cardiac centers in Cameroon: Insights from the National pacemaker registry
| Autor: | William Ngatchou, L. Kuate Mfeukeu, Anastase Dzudie, R. Hentchoya, Jerome Boombhi, Sidick Mouliom, Samuel Kingue, C. Petipe Nkappe, Cabral Tantchou, U.A. Metogo Mbengono, M. Ngowe Ngowe, L. Nganhyim, A. Nzali, C. Ngongang Ouankou, M. Ouankou, Félicité Kamdem, H. Ba, C. Kouam Kouam, Jules Ndjebet, P. Mintom, Martin Hongieh Abanda, Clovis Nkoke, B. Barche |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Bradycardia medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment 030204 cardiovascular system & hematology Health Services Accessibility Cardiac pacemaker Electrocardiography Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Palpitations Humans Cameroon Registries Atrioventricular Block Child Survival rate Aged Retrospective Studies Sick Sinus Syndrome medicine.diagnostic_test business.industry Hazard ratio Cardiac Pacing Artificial Middle Aged Prognosis medicine.disease Treatment Outcome Quality of Life Cardiology Female Symptom Assessment medicine.symptom Cardiology and Cardiovascular Medicine business Atrioventricular block Cohort study |
| Zdroj: | Annales de Cardiologie et d'Angéiologie. 70:18-24 |
| ISSN: | 0003-3928 |
| Popis: | Background There is evidence that cardiac pacemakers improve symptoms and quality of life in patients with severe bradycardia. Globally, the number of pacemaker implantations is on the rise. However, the associated high-cost limits pacemaker's accessibility in low resource settings. This study aimed to investigate access to pacemakers and the long-term outcome of patients requiring a pacemaker. Method We conducted a cohort study in 03 health care structures in Cameroon. Participants aged at least 18 years with indication for a permanent pacemaker between January 2010 and May 2016 were included. Clinical profile, electrocardiography, pacemaker implantation parameters were recorded. Long-term survival was studied by event-free analysis using the Kaplan-Meier method. Results In total, 147 participants (mean age 67.7 ± 13.7 years, female 58.5%) were included. Fatigue (78.7%), dyspnoea (77.2%), dizziness (47.1%) and palpitations (40.4%) were the main symptoms while syncope was present in 35.7% of patients. The main indication for cardiac pacemaker was atrioventricular block (85.3%). Forty (27.2%) could not be implanted with 34 (85%) of participants highlighting cost of intervention as main reason. VVIR was the main mode of stimulation (70.5%). Of 125 patients in which follow-up was ascertained, 17(13.5%) died after a median survival time of 2.8 years post diagnosis [IQR: 1.8–4.2]. The survival curve was better in participants with a pacemaker with a Hazard ratio of 2.7 [CI: 1.0–7.3, P = 0.045]. Conclusion Our patients with severe heart blocks presented late and more than a quarter did not have access to pacemaker but its implantation multiplied the survival rate by 2.7 times at approximately 3 years post diagnosis. Improving early detection of heart blocks and access to cardiac pacing to reduce mortality shall be a key future priority. |
| Databáze: | OpenAIRE |
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