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

Autor: Jonas Kologo, Adama Kane, Ashley Chin, Mohamed Awad, Romain Houndolo, George Millogo, Bongani M. Mayosi, George Nel, Marcus Ngantcha, Emmy Okello, Zaheer Yousef, Aimé Bonny, Mohammed Abdullahi Talle, Amam Mbakwem, Bundhoo Kaviraj, Ibrahim Ali Toure, Mahmoud U Sani, Mohamed Jeilan, Anastase Dzudie, Kamilu M. Karaye, Eloi Marijon
Rok vydání: 2017
Předmět:
medicine.medical_specialty
Pacemaker
Artificial

Cardiac Electrophysiology and Ablation
medicine.medical_treatment
Population
Advisory Committees
Cardiac electrophysiology
MEDLINE
Cardiac resynchronization therapy
Cardiology
Catheter ablation
030204 cardiovascular system & hematology
Implantable cardioverter-defibrillator
Cardiac Resynchronization Therapy
Prosthesis Implantation
03 medical and health sciences
0302 clinical medicine
Cardiac Conduction System Disease
Clinical Research
Physiology (medical)
Internal medicine
Health care
medicine
Per capita
Humans
030212 general & internal medicine
Health Workforce
education
Societies
Medical

education.field_of_study
business.industry
Interventional electrophysiological procedures
Cardiac arrhythmia
Heart
Arrhythmias
Cardiac

Health Care Costs
Defibrillators
Implantable

Pacemaker
Catheter
Africa
Catheter Ablation
Health Expenditures
Cardiology and Cardiovascular Medicine
business
Electrophysiologic Techniques
Cardiac
Zdroj: Europace
ISSN: 1532-2092
Popis: 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.
Databáze: OpenAIRE