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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 31, No 3, May/June 2020
164
AFRICA
Following presentations on supraventricular tachycardia
management based on current international guidelines, Dr
Mohamed Salim (Kenya) presented a pre-recorded case from
the only electrophysiology laboratory with three-dimensional
mapping capabilities in East and Central Africa (Mombasa,
Kenya) where a patient with a manifest right-sided accessory
pathway underwent successful ablation with a mapping system
without fluoroscopy.
The birth of AFHRA
The opening ceremony of the meeting served as the official
launch of AFHRA and was officiated by PASCAR president
Saad Subahi, executive officer George Nel and interim president
of AFHRA, Aimé Bonny. This session invited an open
discussion between clinicians, industry players, funders and
healthcare advocates on multidimensional and collaborative
strategies to improve access to arrhythmia care in Africa in
alignment with the vision of AFHRA. Emphasis was placed
on success stories of trans-national cardiology training under
PASCAR’s training network. Dr Akwanalo, the first fellow
to train under the PASCAR fellowship programme in South
Africa, has subsequently implanted more than 120 pacemakers
in rural Kenya in three years and gave his perspectives on
the opportunities and challenges of establishing a pacemaker
programme outside the capital of Kenya.
The meeting was attended by 217 specialists with an
audience of healthcare practitioners of diverse cadres, including
arrhythmologists from the five PASCAR regions, including
Egypt (10), Algeria (one), Sudan (four), Nigeria (three), Ghana
(one), Cameroon (three), Democratic Republic of Congo (one),
Ethiopia (three), Rwanda (one), Tanzania (three), Uganda (two),
Kenya (> 100), South Africa (four), Mauritius (one), and
from North America, Europe and Asia. Although the majority
of attendees were cardiologists, a substantial minority were
nurses and allied healthcare professionals. Fellows-in-training
comprised 15 attendees, mostly from Egypt, Kenya and Tanzania.
Perspective, opportunities and future directions
PASCAR-affiliated societies are the future of accessible,
extensive and specialised cardiology services across Africa. They
have great potential to foster training and advocacy, and to
levy support from local and international stakeholders. Annual
or other interval societal meetings are an invaluable forum to
teach, connect, review performance and strategise for the future.
AFHRA has determined to plan an annual Cardiorhythm Africa
congress with expectations of increased visibility and successive
increases in delegate numbers and representation of all African
countries. The cardiorhythm meetings will serve as fora for
annual review and evaluation of AFHRA’s activities, annual
general meetings and for setting of key milestones and strategies.
The next Cardiorhythm Africa meeting will be held in 2021,
with the venue to be announced in August 2020. The AFHRA
scientific board agreed to maintain the current programme
format of a syndrome-based approach but will introduce
sessions for allied health professionals and non-cardiologists,
and broaden workshops to provide a focus on diagnostic
strategies for arrhythmia care in underserved parts of Africa and
to build a referral network.
Conclusion
Cardiorhythm Africa 2020, the first meeting of AFHRA, was
an ambitious project that met its objectives. Specifically, it
created a pan-African conversation on access to arrhythmia care
in Africa; allowed the creation of a pan-African arrhythmia
network; facilitated the formation of the AFHRA executive
council; and provided physicians with information on regional
and international expertise with a view to developing referral
links for both patient care and training. During the meeting we
were able to conduct a more detailed and up-to-date survey of
arrhythmia practice from all participating countries. Scientific
sessions spanning resource-constrained arrhythmia management
through to novel and advanced techniques created a framework
for all of these successes. The programme design and objectives
of Cardiorhythm Africa as an AFHRA launch meeting may
provide a blueprint for other affiliate groups of PASCAR.
References
1. Bonny A, Ngantcha M, Yuyun M, Karaye KM, Scholtz W, Suliman A,
et al
. Cardiac arrhythmia services in Africa from 2011 to 2018: the second
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cardiac arrhythmias and pacing.
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2020;
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2. Bonny A, Ajijola OA, Jeilan M, Sani M, Yousef Z, Yuyun MF,
et al
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Cardiac pacing in sub-Saharan Africa.
Cardiovasc J Afr
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31
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3. Talle MA, Bonny A, Scholtz W, Chin A, Nel G, Karaye KM,
et al
. Status
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Congress group photo