title: Pacemakers implantation and radiofrequency catheter ablation procedures during medical missions in Morocco: an 8-year experience.
abstract: OBJECTIVE
  Radiofrequency catheter ablation (RFCA) for arrhythmias in the context of short-term medical missions (MM) in a developing country has not been reported so far. We describe here our experience with RFCA and pacemaker implantation in Morocco with a fully portable electrophysiological (EP) system under the auspice of the Monaco-Morocco Cardiology Association.
  
  
  RESULTS
  Since November 2007, two to three MM (mean duration 4 days including transportation) per year were conducted (including two physicians and one nurse from Monaco) and were alternately located in Marrakech, Fes, Agadir, Casablanca, Rabat, Essaouira, and Oujda. All patients' files were sent by local teams and/or referring Moroccan cardiologists before MM. Each case was discussed with the Monaco EP team before the MM. Pacemakers and leads were donated by companies (Sorin Group, Medtronic, Saint-Jude Medical). The EP system (EP Tracer, CardioTek) as well as diagnostic/ablation catheters were brought for RFCA procedures. After the procedures, follow-up was performed by local teams. Procedures took place in gynaecological or orthopaedic operating room, or, when available, in the interventional cardiology cathlab. Thirty-one RFCA were performed during 11 MM (atrioventricular node re-entrant tachycardia = 12; atrioventricular re-entrant tachycardia/Mahaïm fibre = 15; typical atrial flutter = 3; ventricular ectopy = 1). Acute success was 93.5% for RFCA. Two major RFCA-related complications occurred (air embolism and complete atrioventricular block). No complication was related to pacemaker implantations (n = 44; mean 4 pacemakers per mission).
  
  
  CONCLUSIONS
  Radiofrequency catheter ablation for arrhythmias in developing countries is technically challenging but feasible, despite technical and cultural difficulties.
authors.affiliation: Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco, 98000 Monaco (Principality) sithi.bun@gmail.com.
authors.forename: Sok-Sithikun
authors.initials: SS
authors.lastname: Bun
authors.affiliation: Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco, 98000 Monaco (Principality).
authors.forename: Decebal Gabriel
authors.initials: DG
authors.lastname: Latcu
authors.affiliation: Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco, 98000 Monaco (Principality).
authors.forename: Abdelkarim
authors.initials: A
authors.lastname: Errahmouni
authors.affiliation: Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco, 98000 Monaco (Principality).
authors.forename: Naïma
authors.initials: N
authors.lastname: Zarqane
authors.affiliation: Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco, 98000 Monaco (Principality).
authors.forename: Khelil
authors.initials: K
authors.lastname: Yaïci
authors.affiliation: Department of Cardiology, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Abdelhamid
authors.initials: A
authors.lastname: Moustaghfir
authors.affiliation: Department of Cardiology, Cheikh Zaid International Hospital, Rabat, Morocco.
authors.forename: Amale
authors.initials: A
authors.lastname: Tazi-Mezalek
authors.affiliation: Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco, 98000 Monaco (Principality).
authors.forename: Nadir
authors.initials: N
authors.lastname: Saoudi
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D001282:Atrial Flutter / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003906:Developing Countries; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008493:Medical Missions; D008875:Middle Aged; D009018:Morocco; D010138:Pacemaker, Artificial; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery*; D013617:Tachycardia, Supraventricular / Q000601:surgery*; D016896:Treatment Outcome
keywords: Catheter ablation; Developing countries; Medical missions; Pacemaker implantation