Challenges in cardiac pacing activities in a subsaharan tertiairy centre

Abstract

Background In sub-Saharan countries except South Africa, cardiac pacing activity is poorly developed due to shortage of qualified personnel and lack of appropriate infrastructures. The Cardiac Centre Shisong inaugurated in 2009 is a well-equipped with ultra-modern technologies institution offering a wide range of non-invasive, invasive procedures and open-heart surgery with extracorporeal circulation. Purpose The objective of the study is to report the cardiac pacing activities of the centre, the follow-up of implanted cases and challenges encountered from the 10th November 2009 till the 10th March 2016. Patients and methods From the 10th November 2010 till 10th March 2016, 130 patients underwent a device implantation in the Cardiac Centre Shisong. Data were extracted from the records of implanted patients. Results In the Cardiac Centre Shisong, for bradypacing were implanted 124 pace makers. Ten patients having atrial fibrillation with low ventricular response benefited from a single chambered pace maker. Sick sinus node was diagnosed in 36 patients; 32 cases benefited from a dual chambered pace maker and 4 from a single chambered pace maker. Seventy-eight cases had complete a trio-ventricular block and were implanted 5–patients single chambered and 73 dual chambered pace makers. In this group were 5 children, 3 with sick sinus disease and 2 had post-surgical complete atrioventricular block. Four intracardiac cardioverter defibrillators were implanted in 4 males, 3 single chamber and 1 double chamber. The resynchronization therapy was performed in two ladies fulfilling the criterias. Complications seen postoperatively and during the follow-up were: pocket infection – 4 cases, 4 leads displacements. Conclusion Bradypacing, tachypacing and cardiac resynchronization therapy are procedures done in the Cardiac Centre Shisong with good results. Our governments should create and sustain centres for the invasive management of cardiovascular diseases.