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Case Reports
. 2020 Apr 1;6(5):244-248.
doi: 10.1016/j.hrcr.2020.03.016. eCollection 2020 May.

An algorithm for managing QT prolongation in coronavirus disease 2019 (COVID-19) patients treated with either chloroquine or hydroxychloroquine in conjunction with azithromycin: Possible benefits of intravenous lidocaine

Raman L Mitra  1 , Steven A Greenstein  1 , Laurence M Epstein  1
Affiliations
Case Reports

An algorithm for managing QT prolongation in coronavirus disease 2019 (COVID-19) patients treated with either chloroquine or hydroxychloroquine in conjunction with azithromycin: Possible benefits of intravenous lidocaine

Raman L Mitra et al. HeartRhythm Case Rep. .
No abstract available

Keywords: Acquired LQTS; Azithromycin; COVID-19; Chloroquine; Drug toxicity; Flow chart; Hydroxychloroquine; Long QT; Pandemic; Proarrhythmia; Torsades de pointes; Ventricular fibrillation.

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Figures

Figure 1
Figure 1
Chest computed tomography of patient on March 16, 2020, showing extensive right lung infiltrates.
Figure 2
Figure 2
A: Electrocardiogram (ECG) showing prolonged QTc of 620 ms using Bazett’s formula after 1 dose of hydroxychloroquine in a patient on azithromycin. B: ECG 30 minutes after administration of 100 mg intravenous (IV) lidocaine with reduction of QTc to 550 ms.
Figure 3
Figure 3
Flow chart to manage effects on QTc with chloroquine, hydroxychloroquine with azithromycin. bpm = beats per minute; Dob = dobutamine; ECG = electrocardiogram; Epi = epinephrine; IV = intravenous; K = serum potassium; LQTS = long QT syndrome; Mg = serum magnesium; NE = norepinephrine; TdP = torsades de pointes.
See this image and copyright information in PMC

References

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