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[Characteristic and evolution of pacemaker complications in a Subsaharan Africa Heart Centre]
K A Adoubi1, I Coulibaly2, J J Ndjessan2
1Institut de cardiologie d'Abidjan, BP V206, Abidjan, Cote d'Ivoire; Université de Bouaké, Bouaké, Cote d'Ivoire.
Insights
Implementing specific preventive measures significantly reduced pacemaker complications in Sub-Saharan Africa. These interventions improved patient outcomes without negatively impacting long-term prognosis, demonstrating the feasibility of quality cardiac pacing.
Area of Science:
- Cardiology
- Medical Devices
- Public Health
Background:
- Sub-Saharan Africa faces challenges in pacemaker implantation due to the working environment and low procedure rates.
- These factors contribute to an increased risk of pacemaker-related complications.
Purpose of the Study:
- To assess the long-term impact of specific preventive measures on pacemaker complications in Sub-Saharan Africa.
Main Methods:
- A retrospective study analyzed pacemaker implantations from June 2006 to June 2016 at the Abidjan Heart Institute.
- Evaluated complication incidence, risk factors, and their effect on patient prognosis.
Main Results:
- 25 major (8.27%) and 14 minor (4.6%) complications occurred in 302 procedures.
- Lead displacement was the most common complication (3.64%).
- Subclavian approach and intraoperative incidents were associated with major complications; however, preventive measures significantly reduced these complications over time.
Conclusions:
- Adapted preventive measures enable quality cardiac stimulation in Sub-Saharan Africa.
- These strategies are crucial for mitigating risks associated with pacemaker implantation in resource-limited settings.
Aim Of The Study:
The working environment and the low rate of pacemaker insertions increase the risk of complications in sub-Saharan Africa. The objective of our work was to assess the impact of specific preventive measures on these complications over the long term.
Patient And Methods:
We conducted a retrospective study of all pacemaker implantations from June 2006 to June 2016 at the Abidjan Heart Institute. We evaluated the incidence of pacemaker complications, their risks factors and their impact on the overall prognosis of patients.
Results:
Three hundred and two procedures were performed in 286 patients (49% male, mean age: 67±12 years), with a predominance of primary implantation (82.8%) of single-chamber ventricular pacemakers (66.6%). Twenty-five major complications (8.27%) and 14 minor (4.6%) occurred with a predominance of lead displacements (3.64%). The major complications were favored by the subclavian approach (P=0.018; OR=2.34; 95% CI [1.16-4.75]) and intraoperative incidents (P=0.02; OR=2.17; 95% CI [1.16-4.75]. The preventive measures taken made it possible to achieve a significant (P=0.017) and linear (P=0.009) reduction of these complications, with no effect the patients prognosis (Log-Rank=0.217; P=0.64).
Conclusion:
Quality cardiac stimulation is possible in Sub-Saharan Africa with preventive measures adapted to the environment.
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