Heart rhythm O2 · 2025
Permanent pacemaker insertion for bradyarrhythmias in a secondary health facility in sub-Saharan Africa.
СтатьяНазвание и аннотация: Перевод в очереди
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Shogade Tolulope Taiwo, Ogunleye Ezekiel Olayiwola, Eyo Catherine, Akpan Francis Aniefiok, Udoh Ekikere Marcel, Udosen Aquaowo, Ukpong Omolara Yewande, Ekpe Eyo
Аннотация
BACKGROUND: Permanent cardiac pacemaker (PPM) insertion has been used clinically since 1960. It is a lifesaving procedure in symptomatic bradyarrhythmia. The experience of PPM implantation in non-Western countries has not been well characterized.
OBJECTIVE: This study reports our experience in pacemaker insertion in the newly remodeled District General Hospital Awa. The Akwa Ibom state government fully sponsored the procedures with state funds; otherwise, patients would have to pay out of pocket.
METHODS: The general hospital is fully equipped with an ultramodern theater with C-arm fluoroscopy and audiovisual facilities, and there is an anteroom in the procedural suite where people can watch for virtual learning. This is the first of its kind.
RESULTS: A single-chamber (VVIR) pacemaker was implanted in all patients. There were no acute complications postsurgery. All patients were followed for at least 3 months. There were no deaths reported at the 3-month follow-up. Device interrogations were performed at the 3-month follow-up visit, and device parameters were all stable with excellent sensing thresholds. Routine follow-up for our center is a regular 2-monthly follow-up in the first year.
CONCLUSION: We conclude that permanent pacemakers can be safely carried out in a well-equipped district general hospital. Most needy patients are likely older, with complete heart block as the commonest indication. However, government and/or nongovernmental organizations need health insurance or subsidization to make it sustainable in low-income countries to which Nigeria belongs.
OBJECTIVE: This study reports our experience in pacemaker insertion in the newly remodeled District General Hospital Awa. The Akwa Ibom state government fully sponsored the procedures with state funds; otherwise, patients would have to pay out of pocket.
METHODS: The general hospital is fully equipped with an ultramodern theater with C-arm fluoroscopy and audiovisual facilities, and there is an anteroom in the procedural suite where people can watch for virtual learning. This is the first of its kind.
RESULTS: A single-chamber (VVIR) pacemaker was implanted in all patients. There were no acute complications postsurgery. All patients were followed for at least 3 months. There were no deaths reported at the 3-month follow-up. Device interrogations were performed at the 3-month follow-up visit, and device parameters were all stable with excellent sensing thresholds. Routine follow-up for our center is a regular 2-monthly follow-up in the first year.
CONCLUSION: We conclude that permanent pacemakers can be safely carried out in a well-equipped district general hospital. Most needy patients are likely older, with complete heart block as the commonest indication. However, government and/or nongovernmental organizations need health insurance or subsidization to make it sustainable in low-income countries to which Nigeria belongs.