ESTABLISHING A CARDIAC ELECTROPHYSIOLOGY LABORATORY IN LOW AND MIDDLE-INCOME COUNTRIES AT A GOVERNMENT HOSPITAL (LAGOS STATE UNIVERSITY TEACHING HOSPITAL [LASUTH]) SETTING: CHALLENGES, EARLY OUTCOMES, AND FUTURE DIRECTIONS
Authors & Affiliations
Onomen Agnes Ehizojie1, Oluwaseye Michael Oladimeji1, Alaba Busola Oladimeji2, Esther Opeyemi Ijaola1, Ramon Moronkola1, Oluwadara Olanrewaju Oduwole3, Ajibola Yusuf Sanda1, Oluronke Tolulope Bamgboye1, Kabirat Iyabode Edun1, Aishah Olawunmi Salaudeen1, Timilehin Esther Idowu1, Oluwaseun Oyeyemi Megbope1, Winnie_Wachiraphan Khlainoi4, Oluwafisayo Lizzy Owoeye5, Alaba Philip Adebola3, Ijeoma Ekeruo6, Oluwaseyi Bolorunduro7, Oladipupo Olafiranye8, Tayo Addo8, Obinnaya Emerole9, Departments of 1Medicine and 2Paediatric, Lagos State University Teaching Hospital, 3Department of Medicine, Lagos State University College of Medicine, Ikeja, Lagos State, 4Boston Scientific, 5Department of Nursing, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria, 6Division of Cardiovascular Medicine, Arrhythmia Care Center, Houston, Texas, 7Division of Cardiovascular Medicine, NOVA Cardiovascular Care, INOVA Fairfax Hospital, Fairfax, Virginia, 8Division of Cardiovascular Medicine, UT Southwestern Medical Center, Dallas, Texas, 9Division of Cardiovascular Medicine, Georgia Heart Physicians, Macon, Georgia, USA
📖 Abstract Content
Cardiac electrophysiology (EP) is essential for the diagnosis and treatment of complex cardiac arrhythmias, yet access remains limited in many low and middle-income countries due to inadequate infrastructure, limited funding, and shortages of trained personnel. This study describes the establishment of a dedicated EP laboratory in a low and middle-income setting, highlighting the implementation process, challenges encountered, and early clinical outcomes.
A retrospective descriptive review was conducted on the planning, establishment, and initial operation of a newly developed cardiac EP laboratory within a tertiary cardiovascular centre. Information on infrastructure development, equipment acquisition, workforce training, procedural implementation, and operational challenges was reviewed.
The establishment of the EP laboratory enabled the introduction of diagnostic electrophysiological studies, catheter ablation, permanent pacemaker implantation, implantable cardioverter-defibrillator (ICD) implantation, and cardiac resynchronization therapy (CRT). The programme improved access to specialized arrhythmia care while reducing the need for overseas referrals. Key challenges included high equipment costs, limited funding, inconsistent supply of consumables, and shortages of skilled personnel. These barriers were addressed through institutional commitment, multidisciplinary collaboration, targeted capacity building, and partnerships with international organizations.
Establishing a cardiac EP laboratory in a low and middle-income environment is feasible with strategic planning, institutional support, and collaborative partnerships. Sustained investment in workforce development, infrastructure, and financing is essential to expand equitable access to advanced cardiac rhythm management services in low and middle-income countries.
