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1. 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.

Author

Bonny, Aimé, Ngantcha, Marcus, Jeilan, Mohamed, Okello, Emmy, Kaviraj, Bundhoo, Talle, Mohammed A, Nel, George, Marijon, Eloi, Sani, Mahmoud U, Yousef, Zaheer, Karaye, Kamilu M, Touré, Ibrahim A, Awad, Mohamed A, Millogo, George, Kologo, Jonas, Kane, Adama, Houndolo, Romain, Dzudié, Anastase, Mbakwem, Amam, and Mayosi, Bongani M

Subjects
ARRHYTHMIA treatment, CARDIAC pacemakers, CARDIAC pacing, CARDIOLOGY, CATHETER ablation, HEART function tests, IMPLANTABLE cardioverter-defibrillators, MEDICAL care costs, MEDICAL societies, POLICY sciences
Abstract

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. [ABSTRACT FROM AUTHOR]

Published
2018
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2. 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

Author

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, and Eloi Marijon

Subjects
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
Abstract

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.

Published
2017

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