Pacemaker need in Africa outpacing resources

The need for pacemakers in Africa will rise as life expectancy and associated cardiovascular diseases increase; however, the pacing field, including appropriate training, facilities and devices, are not sufficient to meet future need, according to an Africa Heart Rhythm Association (AFHRA) statement published in the Journal of the American College of Cardiology.

According to the paper, a recent Pan-African Society of Cardiology study found that pacemakers are not implanted in about 20% of African countries. In African countries that do perform pacing, sites and trained implanters are few, with 17 countries having fewer than five centers each. The median implantation rate in 2016 in Africa was 2.66%, which is 200-fold lower than Europe.

The statement examines four main barriers to pacing in Africa—lack of skilled implanters, lack of facilities for implantation, high cost of devices and lack of government support—and offers solutions for how to address these barriers. Researchers focus on improving local training and fellowship programs so trainees do not have to leave the continent for specialized instruction, collaborating with local governments to subsidize equipment, and ensuring quality assurance of implanting centers and clinicians through AFHRA oversight.