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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 2, March/April 2018
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AFRICA
countries. In general, parenteral medications were less available,
making the management of life-threatening arrhythmias quite
challenging.
Anticoagulants: the increasing burden of atrial fibrillation
(Afib) in Africa underscores the need for proper diagnosis and
management in order to better prevent stroke and heart failure.
Vitamin K antagonists (VKAs) were widely available in Africa
(Table 4) but their optimal use is challenging. Two-thirds of the
REMEDY Afib study patients with a CHA
2
DS
2
–VASC score
>
1 were on oral anti-coagulation but only 27.4% had INR in the
therapeutic range.
5
No
Asia
Europe
USA
Africa (another country)
58%
34%
2%
3%
3%
Fig. 3.
Centres where short-term fellowship in cardiac pacing
was obtained by cardiologists practicing in Africa;
58% have not had formal fellowship training in cardiac
pacing.
Africa (current country)
Asia
Europe
USA
Africa (another country)
34%
42%
17%
5%
2%
Fig. 2.
Centres where primary training in cardiac pacing was
obtained by cardiologists practicing in Africa. More
than 50% of the cardiologists were trained in Africa.
Fig. 4.
Availability of drugs used for unmasking covert cardiac arrhythmias.