在撒哈拉以南非洲的一家二级卫生机构中,永久性起搏器插入治疗慢性心律失常

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Tolulope Taiwo Shogade MBChB, MWACP, FMCP , Ezekiel Olayiwola Ogunleye MBBS MSc, FWACP , Catherine Eyo MBBS, FWACS , Francis Aniefiok Akpan MBBCh, FWACS , Ekikere Marcel Udoh MBBCh, MWACP , Aquaowo Udosen MBBCh, FWACP , Omolara Yewande Ukpong MBBS, MWACP , Eyo Ekpe MBBS, FWACS, FMCS, FACS
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引用次数: 0

摘要

自1960年以来,永久性心脏起搏器(PPM)插入已在临床上使用。这是治疗症状性慢性心律失常的救命方法。非西方国家的PPM植入经验尚未得到很好的描述。目的报道我们在新改建的阿瓦区总医院进行心脏起搏器置入的经验。阿夸伊博姆州政府用国家资金全力赞助这些程序;否则,病人将不得不自掏腰包。方法综合医院配备了超现代化的c臂透视和视听设备的剧场,并在手术套间设有会客室,可观看虚拟学习。这是第一次。结果所有患者均植入单腔(VVIR)起搏器。术后无急性并发症。所有患者随访至少3个月。随访3个月无死亡报告。随访3个月时对设备进行问询,设备参数均稳定,感知阈值良好。我们中心的常规随访是第一年2个月的定期随访。结论在设备完善的地区综合医院,永久性心脏起搏器的使用是安全的。大多数有需要的患者可能年龄较大,完全性心脏传导阻滞是最常见的适应症。然而,政府和(或)非政府组织需要医疗保险或补贴,才能使尼日利亚所属的低收入国家的医疗保险可持续发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Permanent pacemaker insertion for bradyarrhythmias in a secondary health facility in sub-Saharan Africa

Permanent pacemaker insertion for bradyarrhythmias in a secondary health facility in sub-Saharan Africa

Background

Permanent cardiac pacemaker (PPM) insertion has been used clinically since 1960. It is a lifesaving procedure in symptomatic bradyarrhythmia. The experience of PPM implantation in non-Western countries has not been well characterized.

Objective

This study reports our experience in pacemaker insertion in the newly remodeled District General Hospital Awa. The Akwa Ibom state government fully sponsored the procedures with state funds; otherwise, patients would have to pay out of pocket.

Methods

The general hospital is fully equipped with an ultramodern theater with C-arm fluoroscopy and audiovisual facilities, and there is an anteroom in the procedural suite where people can watch for virtual learning. This is the first of its kind.

Results

A single-chamber (VVIR) pacemaker was implanted in all patients. There were no acute complications postsurgery. All patients were followed for at least 3 months. There were no deaths reported at the 3-month follow-up. Device interrogations were performed at the 3-month follow-up visit, and device parameters were all stable with excellent sensing thresholds. Routine follow-up for our center is a regular 2-monthly follow-up in the first year.

Conclusion

We conclude that permanent pacemakers can be safely carried out in a well-equipped district general hospital. Most needy patients are likely older, with complete heart block as the commonest indication. However, government and/or nongovernmental organizations need health insurance or subsidization to make it sustainable in low-income countries to which Nigeria belongs.
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来源期刊
Heart Rhythm O2
Heart Rhythm O2 Cardiology and Cardiovascular Medicine
CiteScore
3.30
自引率
0.00%
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审稿时长
52 days
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