Project Pacer International, a nonprofit Boston, Massachusetts based organization that is dedicated to the provision of cardiac therapy to indigent patients in the developing world, recently completed its first visit to Nairobi, Kenya. Project Pacer International was founded in 1988 and has a long track record of providing pacing and electrophysiology services (as well as interventional cardiology) in the developing world.

   Our main focus in the last 20 years has been in India and South America. In Bolivia, where Chagas’ disease is endemic and the need for pacing therapy is substantial, we have developed a close relationship with local cardiologists and now have an active practice of more than 200 patients with implanted devices.¹ Recently, however, we have broadened our horizons to include Morocco, and now Kenya.

   Our host institution was the Aga Khan University Hospital, Nairobi (AKUHN), located in suburban Nairobi. The Aga Khan University Hospital is a well-funded private, nonprofit 254-bed institution dedicated to the needs of the people of East Africa. This teaching institution provides opportunities to staff and physicians alike as part of the Aga Khan Development Network, dedicated to improving the living conditions and opportunities in over 20 of the poorest countries in the developing world.

   As the economic development of Africa continues, tobacco consumption as well as other cardiac risk factors increases and the prevalence of heart disease consequently rises.² Treatment options for patients in this resource-poor society are limited. To date, patients in East and Central Africa in need of device-based or interventional cardiac electrophysiology therapy have to travel abroad to receive treatment, often venturing to South Africa, India, Europe or the U.S. As a result, the treatment is cost prohibitive for the vast majority of citizens.

   The interventional cardiologist at AKUHN, trained at The Western Pennsylvania Hospital in Pittsburgh, Pennsylvania, along with his staff had coordinated in advance the evaluation of patients to be considered for electrophysiology procedures. Our visiting group comprised of 2 electrophysiologists and 2 cardiovascular technologists with extensive EP lab experience. Together, we evaluated all of the patients and selected many of them to undergo elective procedures over a 4-day period ranging from catheter ablation to cardiac resynchronization defibrillator implantation.