Cardiac Pacing in Sub-Saharan Africa: JACC International.

Many parts of the developing world, especially Sub-Saharan Africa, completely lack access to cardiac pacing. The authors initiated a multinational program to implement cardiac pacing in 14 countries in Sub-Saharan Africa (1996 to 2018), aiming to eventually build self-sustainable capacity in each country. This was based on an "on-site training" approach of performing procedures locally and educating local health care teams to work within resource-limited settings, with prospective evaluation of the program.

Cardiac pacing challenge in Sub-Saharan Africa environnement: experience of the Cardiology Department of Teaching Hospital Aristide Le Dantec in Dakar.

Background: Cardiac pacing is a growing activity in Sub-Saharan Africa. There is little data on the characteristics of this interventional treatment in our regions. The goal was to evaluate the results of cardiac pacing in a referral service in sub-Saharan Africa.

Prevalence, clinical characteristics and outcomes of valvular atrial fibrillation in a cohort of African patients with acute heart failure: insights from the THESUS-HF registry.

Introduction: Rheumatic heart disease (RHD) is the commonest cause of valvular heart disease and a common cause of heart failure in sub-Saharan Africa (SSA). Atrial fibrillation (AF) complicates RHD, precipitates and worsens heart failure and cause unfavourable outcomes. We set out to describe the prevalence, clinical characteristics and outcomes of valvular atrial fibrillation in a cohort of African patients with acute heart failure (AHF).

Risk assessment of the occurrence of sudden death related to hypertrophic cardiomyopathy in Dakar.

Aim: The aim of this study was to assess of the risk of sudden death in a population of hypertrophic cardiomyopathy patients in Dakar.

Methods: This was a transverse study at the cardiology clinic of Aristide Le Dantec Hospital from January 2014 to June 2015. We used the European Society of Cardiology risk score to calculate this risk.

[Epidemiological features of cardiorenal syndrome: a study of 36 cases in the Cardiology Department in Dakar].

Introduction: Cardiorenal syndrome (CRS) is a pathophysiologic disorder of the heart and the kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. In Africa, particularly in Senegal, the incidence of cardiorenal syndrome is not accurately known. This study aimed to assess the prevalence of CRS in the Cardiology Department.

Marfan syndrome and cardiovascular complications: results of a family investigation.

Background: Cardiovascular complications in Marfan syndrome (MFS) make all its seriousness. Taking as a basis the Ghent criteria, we conducted a family screening from an index case. The objective was to describe the clinical characteristics of MFS anomalies and to detect cardiovascular complications in our patients.

Obstructive Primary Cardiac T-Cell Lymphoma: A Case Report from Senegal.

BACKGROUND Cardiac lymphoma is a rare entity, defined by the non-extra cardiac location at diagnosis. CASE REPORT Our patient was a 32-year-old female with no particular medical history, who presented with right heart failure with recurrent ascites and pleural effusion. There was a progressive worsening exertional dyspnea.

[Clinical, electrocardiographic and echocardiographic aspects in elderly hypertensive patients in Senegal].

Introduction: Arterial hypertension (HTA) in the elderly is an independent risk factor for cardiovascular disease. Our study aims to describe the clinical, electrocardiographic and echocardiographic aspects of Arterial hypertension in elderly patients.

Methods: We conducted a descriptive, cross-sectional study from January to September 2013.

Development of the roadmap for reducing cardiovascular morbidity and mortality through the detection, treatment and control of hypertension in Africa: report of a working group of the PASCAR Hypertension Task Force.

The fourth Pan-African Society of Cardiology (PASCAR) hypertension taskforce meeting was held at the Yaoundé Hilton Hotel on 16 March 2016. Its main goals were to update and facilitate understanding of the PASCAR roadmap for the control of hypertension on the continent, to refine the PASCAR hypertension algorithm, and to discuss the next steps of the PASCAR hypertension policy, including how the PASCAR initiative can be customised at country level. The formation of the PASCAR coalition against hypertension, the writing group and the current status of the PASCAR hypertension policy document as well as the algorithm were presented to delegates representing 12 French-speaking countries.

Bi treatment with hydralazine/nitrates vs. placebo in Africans admitted with acute HEart Failure (BA-HEF).

Aims: Patients with acute heart failure (HF) in Africa are rarely being treated with a hydralazine/nitrates combination. Therefore the effect of this treatment was studied here.

Methods And Results: The study was planned to enrol 500 patients during an acute HF admission, from nine sub-Saharan African countries.

Optimizing the management of acute coronary syndromes in sub-Saharan Africa: A statement from the AFRICARDIO 2015 Consensus Team.

Background: Whereas the coronary artery disease death rate has declined in high-income countries, the incidence of acute coronary syndromes (ACS) is increasing in sub-Saharan Africa, where their management remains a challenge.

Aim: To propose a consensus statement to optimize management of ACS in sub-Saharan Africa on the basis of realistic considerations.

Methods: The AFRICARDIO-2 conference (Yamoussoukro, May 2015) reviewed the ongoing features of ACS in 10 sub-Saharan countries (Benin, Burkina-Faso, Congo-Brazzaville, Guinea, Ivory Coast, Mali, Mauritania, Niger, Senegal, Togo), and analysed whether improvements in strategies and policies may be expected using readily available healthcare facilities.

The VALVAFRIC study: A registry of rheumatic heart disease in Western and Central Africa.

Background: There are few African data available on rheumatic heart disease (RHD).

Aim: To provide data on the clinical characteristics and treatment of patients with RHD hospitalized in sub-Saharan Africa.

Methods: The VALVAFRIC study is a multicentre hospital-based retrospective registry of patients with RHD hospitalized in African cardiology departments from 2004 to 2008.

Fatal evolution of a huge right atrial free-floating thrombus.

Right atrial thrombus is a rare medical emergency that should be suspected in all cases of pulmonary embolism, and rapid action should be taken to ensure a timely, proper management.

Acute coronary syndrome in young Sub-Saharan Africans: a prospective study of 21 cases.

Background: Coronary heart disease remains the leading cause of death in developed countries. In Africa, the disease continues to rise with varying rates of progression in different countries. At present, there is little available work on its juvenile forms.

Heart rate variability on antihypertensive drugs in black patients living in sub-Saharan Africa.

Background: Compared with Caucasians, African Americans have lower heart rate variability (HRV) in the high-frequency domain, but there are no studies in blacks born and living in Africa.

Methods: In the Newer versus Older Antihypertensive agents in African Hypertensive patients trial (NCT01030458), patients (30-69 years) with uncomplicated hypertension (140-179/90-109 mmHg) were randomized to single-pill combinations of bisoprolol/hydrochlorothiazide (R) or amlodipine/valsartan (E). 72 R and 84 E patients underwent 5-min ECG recordings at randomization and 8, 16 and 24 weeks.

Sinus venosus atrial septal defect: a rare cause of misplacement of pacemaker leads.

Routine implantation of pacemakers and implantable cardioverter defibrillators is not commonly associated with complications. However, in some cases we see misplacement of pacemaker leads which is most often related to the presence of underlying cardiac anomalies. We report the case of misplacement of a pacemaker lead into the left ventricle of a 56-year-old patient paced in VVI/R mode and with a tined type pacemaker lead because of a symptomatic complete atrioventricular block.

Combination of left ventricular noncompaction and partial atrioventricular canal defect in a 21-year-old male: a case report.

Introduction: Left ventricular noncompaction (LVNC) is classified as a genetic cardiomyopathy characterized by a progressive systolic dysfunction. It may occur alone or in association with congenital cardiac anomalies. The combination of left ventricular noncompaction with partial atrioventricular canal defect is rare and has not, to our knowledge, been described previously.

The causes, treatment, and outcome of acute heart failure in 1006 Africans from 9 countries.

Background: Acute heart failure (AHF) in sub-Saharan Africa has not been well characterized. Therefore, we sought to describe the characteristics, treatment, and outcomes of patients admitted with AHF in sub-Saharan Africa.

Methods: The Sub-Saharan Africa Survey of Heart Failure (THESUS-HF) was a prospective, multicenter, observational survey of patients with AHF admitted to 12 university hospitals in 9 countries.

Progress report on the first sub-Saharan Africa trial of newer versus older antihypertensive drugs in native black patients.

Background: The epidemic surge in hypertension in sub-Saharan Africa is not matched by clinical trials of antihypertensive agents in Black patients recruited in this area of the world. We mounted the Newer versus Older Antihypertensive agents in African Hypertensive patients (NOAAH) trial to compare, in native African patients, a single-pill combination of newer drugs, not involving a diuretic, with a combination of older drugs including a diuretic.

Methods: Patients aged 30 to 69 years with uncomplicated hypertension (140 to 179/90 to 109 mmHg) and ≤2 associated risk factors are eligible.

A cross-sectional evaluation of venous thromboembolism risk and use of venous thromboembolism prophylaxis in hospitalized patients in Senegal.

Background: Venous thromboembolism is a common and preventable cause of morbidity and mortality in hospitalized patients. There is a lack of data on the distribution of risk factors and prophylaxis practices in sub-Saharan Africa.

Aim: To assess the prevalence of venous thromboembolism risk in hospitalized patients and to determine the proportion of at-risk patients who receive prophylaxis.

Pregnancy in women with heart disease in sub-Saharan Africa.

Background: Although previous studies showed that pregnancy with heart disease is associated with significant complications, few focused on patients with valvular heart disease in sub-Saharan Africa.

Methods: We report maternal and foetal outcomes in 50 pregnant women with heart disease admitted to the Department of Cardiology of the University of Dakar, during an 8-year period.

Results: Rheumatic heart disease was observed in 46 women, seven of whom had previously been operated on.

Rationale and design of the Newer Versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) trial.

Background: Sub-Saharan Africa experiences an epidemic surge in hypertension. Studies in African Americans led to the recommendation to initiate antihypertensive treatment in Blacks with a diuretic or a low-dose fixed combination including a diuretic. We mounted the Newer versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) trial to compare in native African patients a fixed combination of newer drugs, not involving a diuretic, with a combination of older drugs including a diuretic.