Evolution of Cardiac Arrythmia Management by Catheter Ablation in Tanzania

Authors

  • Yona Gandye Jakaya Kikwete Cardiac Institute – Department of Electrophysiology and Pacing – Dar es Salaam, Tanzania.
  • Mervat Aboulmaaty Ain Shams University – Department of Cardiology and Electrophysiology – Cairo, Egypt. https://orcid.org/0000-0002-9032-4484
  • Amy Bonny University of Douala – Department of Internal Medicine – Gyneco-Obstetric and Pediatric Teaching Hospital – Douala, Cameroon.
  • Mathew Sackett Central Heart and Vascular Institute – Madactari, Africa.
  • Khuzeima Khanbhai Jakaya Kikwete Cardiac Institute – Department of Electrophysiology and Pacing – Dar es Salaam, Tanzania.
  • Pedro Pallangyo Jakaya Kikwete Cardiac Institute – Department of Electrophysiology and Pacing – Dar es Salaam, Tanzania. https://orcid.org/0000-0002-6720-5110
  • Henry Mayala Jakaya Kikwete Cardiac Institute – Department of Electrophysiology and Pacing – Dar es Salaam, Tanzania. https://orcid.org/0000-0001-6484-6505
  • Mohamed Elalfy Ain Shams University – Department of Cardiology and Electrophysiology – Cairo, Egypt.
  • Smitha Bhalia Jakaya Kikwete Cardiac Institute – Department of Electrophysiology and Pacing – Dar es Salaam, Tanzania.
  • Mohamed Janabi Ain Shams University – Department of Cardiology and Electrophysiology – Cairo, Egypt.

DOI:

https://doi.org/10.24207/jca.v37i1.3475

Keywords:

Catheter ablation, Cardiac arrhythmia management, Healthy system infrastructure

Abstract

In Tanzania, despite the expansion of cardiovascular management through the expansion of health system infrastructure to combat cardiovascular diseases, radiofrequency ablation of cardiac arrhythmias remains a major challenge as the current management with catheter ablation is inaccessible to the majority. Several limitations for developing invasive arrhythmia care are identified: lack of manpower, healthcare resources, health systems challenges, high cost of consumables, healthcare financing challenges and limited antiarrhythmic medications. The proposed solutions to address the unmet are: inauguration of a domestic arrhythmia society with dedicated prioritized academic programs, advocacy for training in the cost-effective conventional approach to arrhythmia ablation, reducing irrational claim deduction from insurers and regulation of central medical store policy, calling the Ministry of Health to implement insurance accreditation of radiofrequency ablation in Tanzania, sensitize the government to offer motivation to candidates pursuing electrophysiology career, the government through the Ministry of Health and education to transform the current training infrastructure to meet current academic needs including radiofrequency ablation services, the creation of training partnerships within Africa to improve local electrophysiology expertise. Radiofrequency ablation using a conventional approach, which is cost-effective, can be adopted to ensure service availability in Tanzania and the Sub-Sahara region. A unique responsibility lies within the government and financers to reinforce the efforts to implement these recommendations and achieve the medical tourism policy in Tanzania.

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Author Biography

Mohamed Elalfy, Ain Shams University – Department of Cardiology and Electrophysiology – Cairo, Egypt.

 

 

References

Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death the Framingham heart study. Circulation. 1998;98(10):946-52. https://doi.org/10.1161/01.cir.98.10.946 DOI: https://doi.org/10.1161/01.CIR.98.10.946

Crandall MA, Bradley DJ, Packer DL, Asirvatham SJ. Contemporary management of atrial fibrillation: update on anticoagulation and invasive management strategies. Mayo Clin Proc. 2009;84(7):643-62. https://doi.org/10.1016/s0025-6196(11)60754-4 DOI: https://doi.org/10.1016/S0025-6196(11)60754-4

Haissaguerre M, Jais P, Shah DC, Arentz T, Kalusche D, Takahashi A, et al. Catheter ablation of chronic atrial fibrillation targeting the reinitiating triggers. J Cardiovasc Electrophysiol. 2000;11(1):2-10. https://doi.org/10.1111/j.1540-8167.2000.tb00727.x DOI: https://doi.org/10.1111/j.1540-8167.2000.tb00727.x

Asirvatham S. Advances in Catheter Ablation: A Burning Trail! Indian Heart J. 2011;63(4):379-85.

Pappone C, Rosanio S, Oreto G, Tocchi M, Gugliotta F, Vicedomini G, et al. Circumferential radiofrequency ablation of pulmonary vein ostia: A new anatomic approach for curing atrial fibrillation. Circulation. 2000;102(21):2619-28. https://doi.org/10.1161/01.cir.102.21.2619 DOI: https://doi.org/10.1161/01.CIR.102.21.2619

Kusumoto F, Prussak K, Wiesinger M, Pullen T, Lynady C. Radiofrequency catheter ablation of atrial fibrillation in older patients: outcomes and complications. J Interv Card Electrophysiol. 2009;25(1):31-5. https://doi.org/10.1007/s10840-008-9346-7 DOI: https://doi.org/10.1007/s10840-008-9346-7

Hsieh MH, Tai CT, Lee SH, Tsao HM, Lin YK, Huang JL, et al. Catheter ablation of atrial fibrillation versus atrioventricular junction ablation plus pacing therapy for elderly patients with medically refractory paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 2005;16(5):457-61. https://doi.org/10.1111/j.1540-8167.2005.40632.x DOI: https://doi.org/10.1111/j.1540-8167.2005.40632.x

O’Neill A. Population growth in Tanzania 2020. 2020.

Mensah GA, Sampson UKA, Roth GA, Forouzanfar MH, Naghavi M, Murray CJL, et al. Mortality from cardiovascular diseases in sub- Saharan Africa, 1990–2013: a systematic analysis of data from the Global Burden of Disease Study 2013. Cardiovasc J Afr. 2015;26(2 Suppl. 1):S6-10. https://doi.org/10.5830/cvja-2015-036 DOI: https://doi.org/10.5830/CVJA-2015-036

Bonny A, Ngantcha M, Scholtz W, et al. Cardiac arrhythmias in Africa: epidemiology, management challenges, and perspectives. J Am Coll Cardiol. 2019;73(1):100-9. https://doi.org/10.1016/j.jacc.2018.09.084 DOI: https://doi.org/10.1016/j.jacc.2018.09.084

Bonny A, Ngantcha M, Jeilan M, Okello E, Kaviraj B, Talle MA, et al. Statistics on the use of cardiac electronic devices and interventional electrophysiological procedures in Africa from 2011 to 2016: report of the Pan African Society of Cardiology (PASCAR) Cardiac Arrhythmias and Pacing Task Forces. Europace. 2018;20(9):1513-26. https://doi.org/10.1093/europace/eux353 DOI: https://doi.org/10.1093/europace/eux353

Global Data Healthcare. Reprocessing of single-use devices lowers costs in cardiac operating suites. Many single-use devices for cardiac and electrophysiology suites are costly and can place a burden on healthcare providers. Medical Device Network; 2022.

World Health Organization. World Health Report: health system financing: the path to universal coverage. Geneva: World Health Organization; 2010.

Haazen D. Making Health Financing Work for Poor People in Tanzania. World Bank Group; 2012. DOI: https://doi.org/10.1596/978-0-8213-9473-1

Odunga M. Tanzania: NHIF to Roll Out New Insurance Packages. Tanzania Daily News [Internet]. 2019 [accessed on August 15, 2020]. Available at: https://allafrica.com/stories/201911280858.html

Amakom U, Ezenekwe UR. Implications of households catastrophic out of pocket (OOP) healthcare spending in Nigeria. J Res Econ Int Finance. 2012;1(5):136-40.

Tayebjee MH, Jeilan M, Bonny A. The state of cardiac electrophysiology in Africa ongoing efforts and future directions. JACC Clin Electrophysiol. 2021;7(10);1328-30. https://doi.org/10.1016/j.jacep.2021.08.012 DOI: https://doi.org/10.1016/j.jacep.2021.08.012

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Published

2024-05-21

How to Cite

Gandye, Y., Aboulmaaty, M., Bonny, A., Sackett, M., Khanbhai, K., Pallangyo, P., Mayala, H., Elalfy, M., Bhalia, S., & Janabi, M. (2024). Evolution of Cardiac Arrythmia Management by Catheter Ablation in Tanzania. JOURNAL OF CARDIAC ARRHYTHMIAS, 37. https://doi.org/10.24207/jca.v37i1.3475

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Section

Electrophysiology

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