Background And Aim: Data are scarce regarding Wolf-Parkinson White Syndrome (WPW) syndrome and asymptomatic pre-excitation in Africa. This study tried to understand the current approaches utilized in Africa for the diagnosis and management of both symptomatic and asymptomatic ventricular pre-excitation.
Methods: The current prospective study was conducted in 20 centers located in 17 countries spanning all areas of Africa. Participants included had ventricular pre-excitation patterns. The data collected included symptoms, locations of accessory pathways (AP) and tachyarrhythmia, risk stratification, as well as acute and long-term management. In addition, we assessed the clinical effectiveness of the centers and the impact of socioeconomic and health metrics on these treatment approaches.
Results: Among 541 participants, 93% were diagnosed with WPW syndrome, with orthodromic atrioventricular reciprocating tachycardia (AVRT) being the most prevalent arrhythmia, affecting 55% of the cases. Approximately 30% of patients in Africa, except for the southern region, received intravenous amiodarone as the first-choice drug for orthodromic AVRT while adenosine was the drug of choice in the Southern region. Electrical cardioversion was the first-line treatment for pre-excited atrial fibrillation and antidromic AVRT across all of Africa. Radiofrequency ablation (RF) was the first long-term therapy option for 88% of patients in all African regions, unlike western and central Africa where it was implemented for less than 30% of patients (p < 0.001). The rates of RF success, long-term recurrence, and complications were 93%, 4.1%, and 3.8%, respectively.
Conclusion: There are significant variations between African regions in terms of diagnostic workup, accessory pathway localizations, and volume of invasive treatment. Countries in Northern and Southern Africa are more advanced than other African countries in terms of modern management strategy. Additional government investments are necessary to enhance diagnostic likelihood and curative treatments as well as to reduce the gap between different regions in Africa.
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http://dx.doi.org/10.1111/jce.16523 | DOI Listing |
J Cardiovasc Electrophysiol
January 2025
Douala Gyneco-obstetric and Pediatric Hospital/University of Douala, Douala, Cameroon.
Mol Genet Genomic Med
December 2024
División de Estudios de Posgrado de la Facultad de Medicina, Universidad Nacional Autónoma de, Mexico City, Mexico.
Cureus
November 2024
Internal Medicine, University of Florida College of Medicine, Gainesville, USA.
Adjustment disorder encompasses maladaptive emotional, behavioral, and physiologic symptomatology that is related to an identifiable psychosocial stressor. Adjustment disorder manifesting as syncope in a patient with Wolf-Parkinson White (WPW) Syndrome is uncommon and has not previously been documented in medical literature. In this case, we discuss a 24-year-old male with a history of WPW who presented with unexplained, episodic syncope in the setting of acute life stressors.
View Article and Find Full Text PDFCureus
September 2024
Cardiology, Lakeland Regional Health, Lakeland, USA.
The inferior vena cava (IVC) is a critical structure for venous return to the heart, and congenital anomalies of the IVC, though rare, can have significant clinical implications during procedures like catheter ablation for arrhythmias. In this case, a 26-year-old male presented with left-sided chest pressure after a routine exercise. Electrocardiography (ECG) revealed a delta wave and shortened PR interval, consistent with Wolf-Parkinson-White (WPW) syndrome, which involves an accessory electrical pathway leading to supraventricular tachycardia.
View Article and Find Full Text PDFTurk J Pediatr
October 2024
Department of Medical Genetics, Ankara Bilkent City Hospital, Ankara, Türkiye.
Background: The mitochondrial DNA (mtDNA) m.3243A>G mutation is one of the most common pathogenic mtDNA variants. The phenotypes associated with this mutation range from asymptomatic induviduals to well-defined clinical syndromes, or non-syndromic mitochondrial disorders.
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