Abstract:
Abstract
Background: Management of life-threatening arrhythmia can be incredibly challenging in advanced health systems.
In sub-Saharan Africa (SSA), this is likely more challenging because of weak pre-hospital and in-hospital critical care
systems. Little is known about life-threatening arrhythmia and their outcomes in SSA. The aim of this study was to
examine the types and outcomes of arrhythmias among haemodynamically unstable patients presenting at a tertiary
hospital in Accra-Ghana.
Method: This was a retrospective case series study conducted at the Korle-Bu Teaching Hospital (KBTH), Accra-
Ghana. Medical records of patients who presented with or developed haemodynamically unstable arrhythmias within
24h of admission from January 2018 to December 2020 were reviewed. The demographic characteristics and clinical
data including outcomes of patients were collected. Descriptive statistics were used and results presented in frequency
tables.
Results: A total of 42 patients with life-threatening arrhythmias were included. Haemodynamically unstable tachyarrhythmias
were the most common arrhythmias found among the patients (66.7%). Approximately 52% of patients
had structural heart diseases whereas 26.2% had no apparent underlying cause or predisposing factor. Cardioversion
(52.4%), commonly electrical (63.6%), and transvenous pacemaker implantation (23.8%) were the common initial
interventions. The majority of the patients (88.1%) survived and were discharged home.
Conclusion: Tachyarrhythmias are the most common haemodynamically unstable arrhythmias seen among
patients presenting emergently in a leading tertiary hospital in Ghana. A high survival rate was observed and cannot
be extrapolated to other healthcare settings in sub-Saharan Africa with limited resources to manage these clinical
entities.
