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J Am Coll Cardiol. 2019 Jan 8;73(1):100-109. doi: 10.1016/j.jacc.2018.09.084.

Cardiac Arrhythmias in Africa: Epidemiology, Management Challenges, and Perspectives.

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Hôpital de District de Bonassama, Douala, Cameroon; University of Douala, Douala, Cameroon; Cameroon Cardiovascular Research Network, Douala, Cameroon. Electronic address:
Cameroon Cardiovascular Research Network, Douala, Cameroon.
Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
Pan-African Society of Cardiology (PASCAR), Department of Medicine, University of Cape Town, Cape Town, South Africa.
Cardiology Institute of Abidjan, Felix Houphouet Boigny University of Abidjan, Abidjan, Ivory Coast.
Department of Cardiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria.
Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
University of Michigan, Ann Arbor, Michigan.


Africa is experiencing an increasing burden of cardiac arrhythmias. Unfortunately, the expanding need for appropriate care remains largely unmet because of inadequate funding, shortage of essential medical expertise, and the high cost of diagnostic equipment and treatment modalities. Thus, patients receive suboptimal care. A total of 5 of 34 countries (15%) in Sub-Saharan Africa (SSA) lack a single trained cardiologist to provide basic cardiac care. One-third of the SSA countries do not have a single pacemaker center, and more than one-half do not have a coronary catheterization laboratory. Only South Africa and several North African countries provide complete services for cardiac arrhythmias, leaving more than hundreds of millions of people in SSA without access to arrhythmia care considered standard in other parts of the world. Key strategies to improve arrhythmia care in Africa include greater government health care funding, increased emphasis on personnel training through fellowship programs, and greater focus on preventive care.


Africa; cardiac arrhythmias; cardiovascular diseases; epidemiology; management


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