Search

The reuse pacemakers is a beneficial technique for patients in countries with a low economic standard of living where health care is almost non-existent. We offered to share the experience of Senegal on the reconditioning of pacemakers. We conducted a retrospective study over a period from January 2015 to December 2020 including all patients who benefited from a reconditioned pacemaker for primary implantation or reimplantation. The criteria for reconditioning pacemakers are the absence of dysfunction or damage and a residual battery life of more than 5 years of the pacemaker. Refurbished pacemakers are acquired either from deceased families or from extraction centers. Sterilization is carried out using phenoxypropanol + benzalkonium chloride solution, 70% ethanol and ethylene oxide. We collected 161 patients during the study period, including 77 men (48%) and 84 women (52%), i.e. a M/F sex ratio of 0.94. The average age of the population was 65 years. Functional symptomatology was dominated by syncope in 54%. Electrocardiographically, 72% of patients were in complete atrioventricular block. A primary implantation was noted in 91.5% of patients. The vascular approach most used during implantation was cephalic in 49.5% of cases. In our series, we noted that 58% of patients had benefited from temporary stimulation before implantation. At implantation, single-chamber stimulation was used in 60% of patients and 46.5% of patients had programming in VVI mode. We had 5.5% major complications with 3% box infection occurring between 3 and 6 months post-implantation and 2.5% pacemaker syndrome. We noted 1 case of death linked to underlying heart disease. Reconditioning of cardiac pacemakers is a safe and beneficial therapeutic strategy for patients. In Senegal, reconditioning has shown satisfactory results. In our countries this technique can be an alternative for certain patients. [ABSTRACT FROM AUTHOR]

Résumé: Introduction: Les maladies cardiovasculaires deviennent avec leurs facteurs de risque un véritable problème de santé en Afrique. Les objectifs de cette étude étaient d’évaluer la prévalence des facteurs de risque cardiovasculaire dans la population générale de la ville de Saint-Louis au Sénégal. Méthodologie: Il s’agit d’une étude transversale, descriptive et analytique réalisée en mai 2010, chez des sénégalais âgés d’au moins 15ans, résidant de la ville de Saint-Louis au Sénégal. Un sondage aléatoire systématique et stratifié en grappes a été réalisé. Les facteurs de risque cardiovasculaire recherchés étaient : hypertension artérielle, diabète, dyslipidémie, tabagisme, obésité, sédentarité et syndrome métabolique. Résultats: L’enquête a concerné 1424 individus dont 983 femmes (69 %). L’âge moyen était de 43,4±17,8ans. La prévalence des facteurs de risque était : hypertension artérielle (46 %), diabète (10,4 %), hypercholestérolémie totale (36,3 %), hyperLDLcholesérolémie (20,6 %), obésité (indice de masse corporelle supérieur ou égal à 30kg/m2) (23 %), obésité abdominale (48,7 % selon l’International Diabetes Federation et 33,2 % selon National Cholesterol Education Program) sédentarité (64,7 %), tabagisme (5,8 %) et syndrome métabolique (15,7 %). On notait une prédominance chez les femmes des facteurs de risque sauf pour le tabagisme et le diabète. Le risque cardiovasculaire global était élevé dans 24,9 % selon le modèle de Framingham, 28,8 % (Société européenne d’hypertension) et 6,1 % (SCORE). Conclusion: Cette enquête retrouve une forte prévalence des facteurs de risque cardiovasculaire dans une population générale sénégalaise, avec une prédominance chez les femmes. Cela doit amener à élaborer une meilleure stratégie de prévention des affections cardiovasculaires. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Diabetes is a major risk factor for coronary artery disease witch may develop insidiously. Several non-invasive methods are used to detect silent myocardial ischaemia, especially in diabetic patients at high cardiovascular risk. We project to screen, by dobutamine stress echocardiography, silent myocardial ischaemia in type 2 diabetics in Senegal. Methodology: We randomly recruited in hospital in Senegal type 2 diabetics aged at least 40 years and a dobutamine stress echocardiography was performed in those selected according to the French Society of Cardiology and the French Language Association for the Study of Diabetes and Metabolic Diseases. Results: Dobutamine stress echocardiography was performed in 79 diabetics at high cardiovascular risk, including 56 women. The average age was 58.8±11.8 years. The exam was positive in 67.1% of cases (53/79), with a predominance of motion abnormalities in anterior territory (83%). Cardiovascular risk factors associated with positivity of test were microalbuminuria (p =0.0001), inactivity (p =0.0001), dyslipidemia (p =0.0002), arterial hypertension (p =0.001), smoking (0.003) and male sex (p =0.004). Conclusion: In Africa, dobutamine stress echocardiography has the advantage of its accessibility and its feasibility. Early detection of silent myocardial ischaemia in diabetics at high risk could optimize their care. [Copyright &y& Elsevier]