A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa
Major structural cardiovascular diseases are associated with cardiac arrhythmias, but their full spectrum remains unknown in sub-Saharan Africa (SSA), which we addressed in this systematic review. Atrial fibrillation/atrial flutter (AF/AFL) prevalence is 16–22% in heart failure, 10–28% in rheumatic...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2020-05-01
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| Series: | Global Heart |
| Subjects: | |
| Online Access: | https://globalheartjournal.com/articles/808 |
| _version_ | 1819051359613222912 |
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| author | Matthew F. Yuyun Aimé Bonny G. André Ng Karen Sliwa Andre Pascal Kengne Ashley Chin Ana Olga Mocumbi Marcus Ngantcha Olujimi A. Ajijola Gene Bukhman |
| author_facet | Matthew F. Yuyun Aimé Bonny G. André Ng Karen Sliwa Andre Pascal Kengne Ashley Chin Ana Olga Mocumbi Marcus Ngantcha Olujimi A. Ajijola Gene Bukhman |
| author_sort | Matthew F. Yuyun |
| collection | DOAJ |
| description | Major structural cardiovascular diseases are associated with cardiac arrhythmias, but their full spectrum remains unknown in sub-Saharan Africa (SSA), which we addressed in this systematic review. Atrial fibrillation/atrial flutter (AF/AFL) prevalence is 16–22% in heart failure, 10–28% in rheumatic heart disease, 3–7% in cardiology admissions, but <1% in the general population. Use of oral anticoagulation is heterogenous (9–79%) across SSA. The epidemiology of sudden cardiac arrest/death is less characterized in SSA. Cardiopulmonary resuscitation is challenging, owing to low awareness and lack of equipment for life-support. About 18% of SSA countries have no cardiac implantable electronic devices services, leaving hundreds of millions of people without any access to treatment for advanced bradyarrhythmias, and implant rates are more than 200-fold lower than in the western world. Management of tachyarrhythmias is largely non-invasive (about 80% AF/AFL via rate-controlled strategy only), as electrophysiological study and catheter ablation centers are almost non-existent in most countries. Highlights: Atrial fibrillation/flutter prevalence is 16–22% in heart failure, 10–28% in rheumatic heart disease, 3–7% in cardiology admissions, and <1% in the general population in sub-Saharan Africa (SSA). Rates of oral anticoagulation use for CHA2DS2VASC score ≥2 are very diverse (9–79%) across SSA countries. Data on sudden cardiac arrest are scant in SSA with low cardiopulmonary resuscitation awareness. Low rates of cardiac implantable electronic devices insertions and rarity of invasive arrhythmia treatment centers are seen in SSA, relative to the high-income countries. |
| first_indexed | 2024-12-21T12:02:41Z |
| format | Article |
| id | doaj.art-6136ab1b7d804ca29c53422d15322cb6 |
| institution | Directory Open Access Journal |
| issn | 2211-8179 |
| language | English |
| last_indexed | 2024-12-21T12:02:41Z |
| publishDate | 2020-05-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Global Heart |
| spelling | doaj.art-6136ab1b7d804ca29c53422d15322cb62022-12-21T19:04:47ZengUbiquity PressGlobal Heart2211-81792020-05-0115110.5334/gh.808767A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan AfricaMatthew F. Yuyun0Aimé Bonny1G. André Ng2Karen Sliwa3Andre Pascal Kengne4Ashley Chin5Ana Olga Mocumbi6Marcus Ngantcha7Olujimi A. Ajijola8Gene Bukhman9Department of Medicine, Harvard Medical School, Boston; Cardiology and Vascular Medicine Service, VA Boston Healthcare System, BostonDistrict Hospital Bonassama, Douala/University of Douala; Homeland Heart Centre, Douala, CM; Centre Hospitalier Montfermeil, Unité de Rythmologie, MontfermeilNational Institute for Health Research Leicester Biomedical Research Centre, Department of Cardiovascular Sciences, University of LeicesterHatter Institute for Cardiovascular Research in Africa, University of Cape TownSouth African Medical Research Council and Department of Medicine, University of Cape TownThe Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape TownInstituto Nacional de Saúde and Universidade Eduardo Mondlane, MaputoHomeland Heart Centre, DoualaRonald Reagan UCLA Medical Center Los AngelesDepartment of Medicine, Harvard Medical School, Boston; Division of Cardiovascular Medicine and Division of Global Health Equity, Brigham and Women’s Hospital, Boston; Program in Global NCDs and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston; NCD Synergies project, Partners In Health, BostonMajor structural cardiovascular diseases are associated with cardiac arrhythmias, but their full spectrum remains unknown in sub-Saharan Africa (SSA), which we addressed in this systematic review. Atrial fibrillation/atrial flutter (AF/AFL) prevalence is 16–22% in heart failure, 10–28% in rheumatic heart disease, 3–7% in cardiology admissions, but <1% in the general population. Use of oral anticoagulation is heterogenous (9–79%) across SSA. The epidemiology of sudden cardiac arrest/death is less characterized in SSA. Cardiopulmonary resuscitation is challenging, owing to low awareness and lack of equipment for life-support. About 18% of SSA countries have no cardiac implantable electronic devices services, leaving hundreds of millions of people without any access to treatment for advanced bradyarrhythmias, and implant rates are more than 200-fold lower than in the western world. Management of tachyarrhythmias is largely non-invasive (about 80% AF/AFL via rate-controlled strategy only), as electrophysiological study and catheter ablation centers are almost non-existent in most countries. Highlights: Atrial fibrillation/flutter prevalence is 16–22% in heart failure, 10–28% in rheumatic heart disease, 3–7% in cardiology admissions, and <1% in the general population in sub-Saharan Africa (SSA). Rates of oral anticoagulation use for CHA2DS2VASC score ≥2 are very diverse (9–79%) across SSA countries. Data on sudden cardiac arrest are scant in SSA with low cardiopulmonary resuscitation awareness. Low rates of cardiac implantable electronic devices insertions and rarity of invasive arrhythmia treatment centers are seen in SSA, relative to the high-income countries.https://globalheartjournal.com/articles/808atrial arrhythmiassupraventricular tachycardiasudden cardiac deathventricular arrhythmiaspacemakerdefibrillatorsub-saharan africa |
| spellingShingle | Matthew F. Yuyun Aimé Bonny G. André Ng Karen Sliwa Andre Pascal Kengne Ashley Chin Ana Olga Mocumbi Marcus Ngantcha Olujimi A. Ajijola Gene Bukhman A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa Global Heart atrial arrhythmias supraventricular tachycardia sudden cardiac death ventricular arrhythmias pacemaker defibrillator sub-saharan africa |
| title | A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa |
| title_full | A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa |
| title_fullStr | A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa |
| title_full_unstemmed | A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa |
| title_short | A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa |
| title_sort | systematic review of the spectrum of cardiac arrhythmias in sub saharan africa |
| topic | atrial arrhythmias supraventricular tachycardia sudden cardiac death ventricular arrhythmias pacemaker defibrillator sub-saharan africa |
| url | https://globalheartjournal.com/articles/808 |
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