Rationale and Design of the Pan-African Sudden Cardiac Death Survey: the Pan-African SCD Study : Cardiovascular Topic

Background: The estimated rate of sudden cardiac death (SCD) in Western countries ranges from 300 000 to 400 000 annually; which represents 0.36 to 1.28 per 1 000 inhabitants in Europe and the United States. The burden of SCD in Africa is unknown. Our aim is to assess the epidemiology of SCD in Africa. Methods: The Pan-Africa SCD study is a prospective; multicentre; community-based registry monitoring all cases of cardiac arrest occurring in victims over 15 years old. We will use the definition of SCD as 'witnessed natural death occurring within one hour of the onset of symptoms' or 'unwitnessed natural death within 24 hours of the onset of symptoms'. After approval from institutional boards; we will record demographic; clinical; electrocardiographic and biological variables of SCD victims (including survivors of cardiac arrest) in several African cities. All deaths occurring in residents of districts of interest will be checked for past medical history; circumstances of death; and autopsy report (if possible). We will also analyse the employment of resuscitation attempts during the time frame of sudden cardiac arrest (SCA) in various patient populations throughout African countries. Conclusion: This study will provide comprehensive; contemporary data on the epidemiology of SCD in Africa and will help in the development of strategies to prevent and manage cardiac arrest in this region of the world

[Biventricular resynchronization in the management of the chronic heart failure]

Heart failure is a major problem of public health, it represents a frequent status among patients with heart disease, and its implications in term of mortality and cost are high. Non Pharmacological treatment of heart failure most commonly designed as cardiac resynchronization therapy [CRT] has demonstrate efficacy to improve functional class, exertion capacity, left ventricular ejection fraction, reduction of mitral regurgitation, and probably mortality at midterm. The most recent studies emphasize on the role of implantable cardioverter defibrillat or [ICD] combined with CRT to reduce mortality. More trials are needed to valid this concept