Focus on the First Ten Years of Cardiac Resynchronization Therapy Practice in Senegal: Modalities and Results in Two Reference Centers in Dakar

<i>Introduction:</i> Cardiac resynchronization therapy (CRT) is an electrical treatment for heart failure with reduced ejection fraction, which has been practiced in Senegal since 2011. This study was conducted to evaluate the first ten years of CRT practice in Senegal<i>. Methods: </i>We conducted a descriptive and analytical cross-sectional study in the cardiology departments of Aristide Le Dantec University Hospital and Principal Hospital of Dakar, covering the period from June 11, 2011, to May 1, 2021. All patients who underwent cardiac resynchronization were included. The studied parameters included clinical, paraclinical, therapeutic, and progression data. Subsequently, patients were contacted for a follow-up evaluation 18 months after device implantation. <i>Results: </i>During the study period, 21 cases were recorded. The mean age was 61 ± 11 years, with a male predominance (sex ratio M/F = 2). At implantation, all patients had dyspnea with 76% classified as NYHA class IV. Sixty-two percent of patients were in sinus rhythm, 14% had complete AV block, and 24% were in atrial fibrillation/atrial flutter. The mean QRS duration was 153.83 ms. The mean left ventricular ejection fraction (LVEF) was 27 ± 6% at baseline (range: 13% to 38%). In our cohort, CRT-P devices accounted for 76% of implants, compared to 24% for CRT-D devices. The primary indication was refractory heart failure despite optimal medical therapy in patients with sinus rhythm, left bundle branch block, QRS duration ≥150 ms, and LVEF ≤35%. Left ventricular leads were quadripolar in 11 cases (52%). One case of coronary sinus dissection without pericardial tamponade was noted. After a mean follow-up of 18 months post-implantation, 10 patients were fully reassessed. Rehospitalization was observed in 33% of patients. Seventeen patients (82%) responded to the therapy. Bivariate analysis showed that rehospitalizations and deaths were statistically linked to non-response. A total of six deaths were recorded, three of which (14%) were cardiac-related.<i> Conclusion: </i>Cardiac resynchronization therapy is an available and effective treatment in Senegal for the optimal management of heart failure patients.