Clinical and Echocardiographic Predictors of Arrhythmias Detected With 24-Hour Holter Electrocardiography Among Hypertensive Heart Failure Patients in Nigeria

Mene-Afejuku, Tuoyo O; Balogun, Michael O.; Akintomide, Anthony Olubunmi; Adebayo, Rasaaq A; Ajayi, Olufemi E.; Amadi, Valentine N; Oketona, Omolola Abiodun; Ikwu, Amanze Nkemjika; Mene-Afejuku, Bamidele; Bamikole, Olaniyi J.

doi:10.1177/1179546817746632

Cited by 4 publications

(5 citation statements)

References 47 publications

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“…Antenatally detected arrhythmias allowed prompt and early referral to our tertiary care center, preventing further deterioration. This study has shown that a high percentage of ECG detected arrhythmias have significant echocardiography and Doppler findings, similar to a study by Mene-Afejuku et al (12). Thus, also warranting that all detected arrhythmias be advised for an echocardiography and colour Doppler study.…”

Section: Discussionsupporting

confidence: 89%

“…Although the diagnostic yield is low in the pediatric age group, Holter monitoring enables cumulative evaluation of heart rhythm and rhythm variability, which is important in diagnosing silent arrhythmias in high risk groups (abnormal heart in cardiomyopathies or postoperative heart) (12,13). Early detection and management play a vital key to survival (14).…”

Section: Svoa Paediatricsmentioning

confidence: 99%

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Arrhythmia Profile in Children Presenting at a Tertiary Care Centre in India - From Fetal Life to Fifteen Years of Age Prabhu Shakuntala, Prabhshara

Shakuntala¹,

Kaur²,

D'costa³

et al. 2023

SVOAPD

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Many of the arrhythmias tend to be asymptomatic and detected incidentally, while some others may be picked up too late after a catastrophic presentation. The goal of this study was to document the arrhythmia profile in children presenting to our tertiary care hospital in India. We also reviewed the early and late outcomes of arrhythmias in these patients (including in isolated and post cardiac surgical patients). Amongst 100 patients with arrhythmias, 35% were detected incidentally for presentations like breathlessness (29%) and refusal to feed. A majority of patients (70%) did not have any underlying structural defect and had no cardiomegaly on chest X-Ray. Of those with structural defects, 90% were congenital with the majority being acyanotic (58%) and would have gone clinically undetected. 19 children (20%) presented with heart failure. Tachyarrhythmias (61%) were more common, and all the immediate deaths were from this group. Bradyarrhythmias were mostly complete heart blocks. Almost half the patients required emergency antiarrhythmics. Holter study was done to check for antiarrhythmic efficacy and to decide regarding pacing. In 48% cases, clinical management was changed based on the Holter report. Almost half the patients required emergency antiarrhythmics (adenosine, isoprenaline, amiodarone). The long-term outcomes were favorable with 50% of the patients not requiring long term antiarrhythmics and most remained asymptomatic. The need for interventional therapy like pacemaker insertion and radiofrequency ablation was less than 2%. Arrythmias in children have varied symptoms and pediatricians need to be aware about this. With optimal management, long term outcomes for these children are usually favorable.

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Section: Discussionsupporting

confidence: 89%

Section: Svoa Paediatricsmentioning

confidence: 99%

Arrhythmia Profile in Children Presenting at a Tertiary Care Centre in India - From Fetal Life to Fifteen Years of Age Prabhu Shakuntala, Prabhshara

Shakuntala¹,

Kaur²,

D'costa³

et al. 2023

SVOAPD

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“…This review identified underlying etiologies of SCA/SCD and ventricular arrhythmias in SSA, with hypertensive heart disease, coronary disease, cardiomyopathy, including peripartum cardiomyopathy, and valvular heart disease, especially rheumatic heart disease being the most common causes of SCA/SCD among adults [ 61 64 67 69 71 72 73 90 ]. Others include malignant arrhythmogenic inherited diseases [ 74 75 76 77 78 79 80 81 84 85 86 87 88 102 103 104 ], pericarditis [ 92 ], endemic parasitic infections [ 9 93 ], pulmonary embolism [ 62 91 ], endomyocardial fibrosis [ 95 ], congenital heart disease [ 96 ], pulmonary embolism [ 62 91 ], pulmonary hypertension [ 61 ], and aortic dissection/rupture [ 64 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have identified hypertensive heart disease, coronary disease, cardiomyopathy, and valvular heart disease, especially rheumatic heart disease, in heterogeneous orders, as the most common causes of SCA/SCD among adults in SSA [61,64,67,69,[71][72][73], while malaria was the prominent cause among the pediat- Cases of hypertrophic cardiomyopathy have been reported in Black Africans [74,75]. Little was known about arrhythmogenic right ventricular cardiomyopathy (ARVC) in SSA, but registry data from South Africa revealed similar clinical presentation and an annual SCA/SCD rate comparable to other large registries from the Western World [76,77].…”

Section: Reported Underlying Etiologies Of Sca/scd and Ventricular Armentioning

confidence: 99%

“…The reported underlying etiologies of SCA/SCD and ventricular arrhythmias in SSA are shown in Table 3 . Studies have identified hypertensive heart disease, coronary disease, cardiomyopathy, and valvular heart disease, especially rheumatic heart disease , in heterogeneous orders, as the most common causes of SCA/SCD among adults in SSA [ 61 64 67 69 71 72 73 ], while malaria was the prominent cause among the pediatric victims [ 57 66 ]. Malignant arrhythmogenic inherited diseases have been identified in Blacks in SSA.…”

Section: Sudden Cardiac Arrest/sudden Cardiac Deathmentioning

confidence: 99%

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A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Yuyun

Bonny

et al. 2020

Global Heart

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Major structural cardiovascular diseases are associated with cardiac arrhythmias, but their full spectrum remains unknown in sub-Saharan Africa (SSA), which we addressed in this systematic review. Atrial fibrillation/atrial flutter (AF/AFL) prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, but <1% in the general population. Use of oral anticoagulation is heterogenous (9-79%) across SSA. The epidemiology of sudden cardiac arrest/death is less characterized in SSA. Cardiopulmonary resuscitation is challenging, owing to low awareness and lack of equipment for life-support. About 18% of SSA countries have no cardiac implantable electronic devices services, leaving hundreds of millions of people without any access to treatment for advanced bradyarrhythmias, and implant rates are more than 200-fold lower than in the western world. Management of tachyarrhythmias is largely noninvasive (about 80% AF/AFL via rate-controlled strategy only), as electrophysiological study and catheter ablation centers are almost non-existent in most countries. Highlights:-Atrial fibrillation/flutter prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, and <1% in the general population in sub-Saharan Africa (SSA).-Rates of oral anticoagulation use for CHA2DS2VASC score ≥2 are very diverse (9-79%) across SSA countries.-Data on sudden cardiac arrest are scant in SSA with low cardiopulmonary resuscitation awareness.-Low rates of cardiac implantable electronic devices insertions and rarity of invasive arrhythmia treatment centers are seen in SSA, relative to the high-income countries.

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Ventricular Arrhythmias in Seniors with Heart Failure: Present Dilemmas and Therapeutic Considerations: A Systematic Review

Mene-Afejuku

Bamgboje²,

Ogunniyi

et al. 2022

CCR

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Background: Heart failure (HF) is a global public health problem which affects over 23 million people worldwide. The prevalence of HF is higher among seniors in the USA and other developed countries. Ventricular arrhythmias (VAs) account for 50% of deaths among patients with HF. We aim to elucidate on the factors associated with VAs among seniors with HF, as well as therapies that may improve outcomes. Methods: PubMed, Web of Science, Scopus, Cochrane Library databases, Science Direct, and Google Scholar were searched using specific key words. The reference lists of relevant articles were searched for additional studies related to HF and VAs among seniors as well as associated outcomes. Results: The prevalence of VAs increases with worsening HF. 24-hour Holter electrocardiogram may be useful in risk stratifying patients for device therapy if they do not meet the criterion of low ventricular ejection fraction. Implantable cardiac defibrillators (ICDs) are superior to anti-arrhythmic drugs in reducing mortality in patients with HF. Guideline directed medical therapy (GDMT) together with device therapy to reduce symptoms may be required. In general, the proportion of seniors on GDMT is low. A combination of ICDs and cardiac resynchronization therapy may improve outcomes in select patients. Conclusion: Seniors with HF and VAs have a high mortality even with the use device therapy and GDMT. The holistic effect of device therapy on outcomes among seniors with HF is equivocal. More studies focused on seniors with advanced HF as well as therapeutic options is therefore required.

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Clinical and Echocardiographic Predictors of Arrhythmias Detected With 24-Hour Holter Electrocardiography Among Hypertensive Heart Failure Patients in Nigeria

Cited by 4 publications

References 47 publications

Arrhythmia Profile in Children Presenting at a Tertiary Care Centre in India - From Fetal Life to Fifteen Years of Age Prabhu Shakuntala, Prabhshara

Arrhythmia Profile in Children Presenting at a Tertiary Care Centre in India - From Fetal Life to Fifteen Years of Age Prabhu Shakuntala, Prabhshara

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Ventricular Arrhythmias in Seniors with Heart Failure: Present Dilemmas and Therapeutic Considerations: A Systematic Review

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