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CARDIOVASCULAR JOURNAL OF AFRICA • Africa STEMI Abstracts, April 2018
12
AFRICA
Presenting Author
Name:
Mohamed Hasham
Surname:
Varwani
Contact Number
+254721200196
Article
English Title
ICD implantation in post MI LV dysfunction: A sub Saharan Centre experience
Category
Heart Failure
English Abstract
Introduction:
Reduced LV systolic function after myocardial infarction increases the risk of sudden cardiac death from
malignant arrhythmias. Several studies have demonstrated that prophylactic ICD implantation in this group of patients
reduces all-cause mortality. Current guidelines recommend ICD therapy for patients who are at least 40 days post MI and
have an LVEF of less than or equal to 35% and are in NYHA class II-III. Worldwide use of ICDs in this population remains
low. ICD therapy in the region is relatively new and data regarding use of ICD therapy in sub Saharan Africa are scarce. We
audited our referral and recommendation patterns to study the utilization and practice of this treatment among cardiologists
at a tertiary level referral facility in Kenya.
Methods:
All patients admitted with a myocardial infarction during the first half of 2017 were included. The echocardio-
grams performed during the admission were reviewed and patients with an LVEF of less than or equal to 35% selected for
chart review. We specifically determined whether patients fulfilling ACC guidelines were offered ICD therapy. Contraindica-
tions to ICD therapy were also noted.
Results:
A total of 92 patients were admitted with a myocardial infarction between January and June 2017. Of these, 14
patients (15.2%) had an LVEF of less than or equal to 35% documented by echocardiogram. None of these patients had a
contraindication to ICD therapy. ICD therapy was offered to 5 patients (35.7%) with a high uptake in the group offered. The
median duration of MI to ICD implantation was 36 days.
Conclusions:
This analysis of the practice among cardiologists at a referral facility in sub Saharan Africa suggests unde-
rutilization of ICD therapy in this setting although the uptake of ICD is relatively in line with current European trends. The
reasons behind underutilization are likely multifactorial and need to be further elucidated.
Authors
Name & Surname Title Expertise
Affiliation
Country
Mohamed Hasham
Varwani
Dr.
Cardiology Fellow
Aga Khan University
Hospital, Nairobi
mhvarwani@gmail.comKenya
Mohamed Jeilan Dr.
Interventional
Cardiologist
Aga Khan University
Hospital, Nairobi
jeilan.mohamed@aku.eduKenya
Disclosure
I hereby agree that I am authorised to submit this abstract on behalf of all the authors and I agree that the copyright of the
above mentioned abstract, shall reside with the Cardiovascular Journal of Africa (Clinics Cardive Publishing (Pty) Ltd.) and
there is no conflict of interest to report.
Authorisation
I agree that the email addresses provided may be used in sending emails related to the Cardiovascular field including our
Editors’ Choice and reviewer invitations etc.