First Permanent Pacemaker Implantations in Burundi: A Case Series of three Patients in a Resource-Limited Setting

Access to permanent pacemaker implantation remains limited in many low-income countries despite its life-saving role in symptomatic bradyarrhythmias. We describe two cases of symptomatic bradyarrhythmia and one case of pacemaker generator replacement managed at Tanganyika Hospital, Burundi. Clinical presentations included complete atrioventricular block and paroxysmal bradycardia confirmed by ECG and Holter monitoring. Permanent pacemaker implantation was performed via transvenous subclavian access under fluoroscopic guidance. Active fixation leads were used for atrial and ventricular positioning. One patient required generator replacement due to battery depletion of a device implanted abroad. All procedures were successful without complications. Device interrogation confirmed appropriate function in all patients. Clinical symptoms resolved rapidly, and discharge occurred within 1–2 days. This case series highlights the feasibility and safety of establishing a local pacemaker implantation programme in a resource-limited setting.