Department of Medicine, University of Ghana Medical School, Korle-Bu Teaching Hospital, Accra, Ghana.
National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana.
BMC Cardiovasc Disord. 2022 Aug 7;22(1):361. doi: 10.1186/s12872-022-02803-6.
Management of life-threatening arrhythmia can be incredibly challenging in advanced health systems. In sub-Saharan Africa (SSA), this is likely more challenging because of weak pre-hospital and in-hospital critical care systems. Little is known about life-threatening arrhythmia and their outcomes in SSA. The aim of this study was to examine the types and outcomes of arrhythmias among haemodynamically unstable patients presenting at a tertiary hospital in Accra-Ghana.
This was a retrospective case series study conducted at the Korle-Bu Teaching Hospital (KBTH), Accra-Ghana. Medical records of patients who presented with or developed haemodynamically unstable arrhythmias within 24h of admission from January 2018 to December 2020 were reviewed. The demographic characteristics and clinical data including outcomes of patients were collected. Descriptive statistics were used and results presented in frequency tables.
A total of 42 patients with life-threatening arrhythmias were included. Haemodynamically unstable tachyarrhythmias were the most common arrhythmias found among the patients (66.7%). Approximately 52% of patients had structural heart diseases whereas 26.2% had no apparent underlying cause or predisposing factor. Cardioversion (52.4%), commonly electrical (63.6%), and transvenous pacemaker implantation (23.8%) were the common initial interventions. The majority of the patients (88.1%) survived and were discharged home.
Tachyarrhythmias are the most common haemodynamically unstable arrhythmias seen among patients presenting emergently in a leading tertiary hospital in Ghana. A high survival rate was observed and cannot be extrapolated to other healthcare settings in sub-Saharan Africa with limited resources to manage these clinical entities.
在先进的医疗体系中，危及生命的心律失常的管理极具挑战性。在撒哈拉以南非洲（SSA），由于院前和院内重症监护系统薄弱，情况可能更为严峻。关于 SSA 危及生命的心律失常及其结局，我们知之甚少。本研究旨在调查加纳阿克拉一家三级医院中血流动力学不稳定患者的心律失常类型及其结局。
这是一项在科勒布教学医院（KBTH）进行的回顾性病例系列研究。回顾了 2018 年 1 月至 2020 年 12 月期间入院 24 小时内出现或发生血流动力学不稳定心律失常的患者的病历。收集了患者的人口统计学特征和临床数据，包括结局。使用描述性统计方法，结果以频率表形式呈现。
共纳入 42 例危及生命的心律失常患者。血流动力学不稳定的心动过速是患者中最常见的心律失常（66.7%）。约 52%的患者有结构性心脏病，而 26.2%的患者无明显的潜在病因或易患因素。电复律（52.4%）、常为电复律（63.6%）和经静脉起搏器植入（23.8%）是常见的初始干预措施。大多数患者（88.1%）存活并出院回家。
在加纳一家领先的三级医院，紧急就诊的患者中最常见的血流动力学不稳定心律失常是心动过速。观察到高存活率，但不能将其推断为资源有限、难以处理这些临床实体的撒哈拉以南非洲其他医疗保健环境。
