Resume Objectifs La stimulation cardiaque au Burkina Faso devient une realite. Le but de notre etude etait d’evaluer cette activite sur cinq ans et apprecier l’impact de la collaboration avec des hopitaux de la region d’Auvergne dans son developpement. Materiel et methodes Etude prospective dans laquelle les patients appareilles et suivis depuis juin 2011 ont ete inclus consecutivement. Les donnees collectees portaient sur les indications, le delai de prise en charge, le type de stimulation, les complications, le cout du traitement, l’education et la qualite de vie du patient opere. Resultats Soixante-neuf patients ont ete appareilles de juin 2011 a juin 2016 dont 45,5 % de femmes. L’âge moyen etait de 69 ans avec des extremes de 35 et de 89 ans. La quasi-totalite des patients (94 %) etait symptomatique (54 % de syncopes et 30 % de vertiges et lipothymies). L’indication principale de la stimulation cardiaque definitive etait le bloc auriculo-ventriculaire complet d’origine degenerative (83 %). Le delai moyen entre l’indication et l’appareillage etait de 8,2 jours et seulement 4 % des patients ont beneficie d’une stimulation temporaire. L’absence de prise en charge financiere constituait le principal motif du retard a la prise en charge. Durant la periode de l’etude, les deux structures de sante ont beneficie d’un appui en materiel de stimulation, d’un plateau technique, et de formations et stages pratiques reguliers. Cette collaboration a permis de pallier l’insuffisance en ressources materielles, humaines et financieres. Nous avons enregistre comme complications, un cas d’exteriorisation de boitier, deux cas d’hematome d’evolution benigne et deux cas de deplacement de sonde. La qualite de vie des patients s’est nettement amelioree, tous les patients operes n’etaient plus symptomatiques. Conclusion L’organisation de la stimulation cardiaque au Burkina Faso est une realite. Des efforts doivent toujours etre faits pour perenniser l’activite et renforcer la collaboration avec des hopitaux du Nord.

Bilan de cinq ans de stimulation cardiaque dans deux structures hospitalières publiques du Burkina Faso : expérience d’une collaboration avec deux centres hospitaliers d’Auvergne

A rare right atrial mass: Hydatid cyst

BACKGROUND Permanent cardiac pacing remains the only effective treatment for chronic, symptomatic bradycardia. In recent years, the role of implantable pacing devices has expanded substantially. AIM To compare the situation of patients with critical brady arrhythmias before and after pacing focusing on indication for pacemaker implantation, frequency of re intervention and early and late complications. METHODS Retrospective study performed over 24 years between 1984 and 2007 at the department of cardiology of Farhat Hached hospital. A total of 234 patients were included, and the database was formed by the patients' files and the protocols of implantation. RESULTS The mean age of patients was 69.5 years. The most frequently reported signs and symptoms before implantation of pace maker were dizzy spells and syncope respectively in 53% and 29.1% of patients. Among the electrocardiographic alterations leading to an indication of pacemaker implantation, atrio-ventricular blocks were the most numerous at 74.4% followed by sinus node disease at 17.1%. Early complications were represented essentially by haematoma and infection of the pocket of pacemaker respectively at 2.9% for each one. After a mean follow up of 6.8 years, 88 patients (45.3%) still free of symptoms. Late complications include lead dislodgement and pacemaker syndrome at 2% for each one. CONCLUSION The results of our study demonstrates that even the rate of complications following pacemaker implantation is not high, the follow-up of patients should be fast, complete, safe, and clear, and should include sufficient documentation.

[Permanent cardiac pacing: about 234 patients].

L'hydatidose cardiaque est une pathologie exceptionnelle. Les localisations cardiaques droites, surtout celles de l'oreillette droite, sont encore plus rares et de pronostic grave. Nous rapportons l'observation de trois cas de kyste hydatique de l'oreillette droite. La premiere patiente est decedee en post-operatoire immediat par defaillance cardiaque droite et saignement tracheal abondant. L'evolution post-operatoire immediate et a moyen terme a ete favorable dans les deux autres cas. Nous insistons sur l'interet de l'echographie cardiaque dans le diagnostic du kyste hydatique dont le contexte clinique est peu evocateur en raison d'une grande latence clinique. La chirurgie cardiaque est necessaire et doit etre precoce dans ce type de localisation vu le risque important d'embolie pulmonaire.

Hydatid cyst of the right atrium

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[Permanent cardiac pacing: about 234 patients].

Hydatid cyst of the right atrium