Outcome of Life-Threatening Arrhythmias Among Patients Presenting in an Emergency Setting at a Tertiary Hospital in Accra-Ghana

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 outcomes and types 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 24 hours of admission from January 2018 to December 2020 were reviewed. The demographic characteristics and clinical data including outcomes of patients were collected. Descriptive statistics was used, and results presented in frequency table. Results: A total of 42 patients with life-threatening arrhythmias were included. Haemodynamically unstable tachyarrhythmias were the commonest arrhythmias found among the patients (70%). Approximately, 52.5% of patients had structural heart diseases (52.5%) whereas 27.5% had no apparent underlying cause or predisposing factor. Cardioversion (44.8%), commonly electrical (31.0%), and pacemaker implantation (34.5%) were the common initial interventions. 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. The high survival rate observed was likely due to the presence of specialists on duty in our facility. This outcome cannot be extrapolated to other healthcare settings in sub-Saharan Africa with limited resources to manage these clinical entities.