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. 2020 Oct:30:100644.
doi: 10.1016/j.ijcha.2020.100644. Epub 2020 Sep 17.

QT interval measurement with portable device during COVID-19 outbreak

Nerea Torres González  1 , Luis Álvarez Acosta  2 , Diego Valdivia Miranda  2 , Alejandro Iriarte Plasencia  1 , Virginia Barreto Cáceres  1 , Marx Rivera Zambrano  1 , Julio Salvador Hernández Afonso  2   3
Affiliations

QT interval measurement with portable device during COVID-19 outbreak

Nerea Torres González et al. Int J Cardiol Heart Vasc. 2020 Oct.

Abstract

Coronavirus Disease 2019 continues to spread and to date, no definitive treatment is available. Overcrowded and under-resourced healthcare centres have had to design different strategies to treat these patients, what includes the control of the electrocardiogram (ECG), as some drugs that have been used to treat this disease may prolong the QT interval as a side effect. During the COVID-19 outbreak, we designed a protocol for monitoring the QT interval using a portable device with Bluetooth connectivity. After a validation study with 50 patients, we found a very good correlation between the QT interval measured both with this device and with the conventional body surface ECG. In this article, we provide a brief overview of the protocol and then analyse the QT changes observed in a group of patients during their hospitalization and treatment for SARS-CoV-2 infection. 81 patients with confirmed SARS-CoV-2 infection were enrolled in the protocol (age 63.4 SD 17.2 years; 70.3% men), while being treated with lopinavir/ritonavir, azithromycin and hydroxychloroquine, both individually or combined. Ten patients developed long drug-related QT interval, and the QT prolongation was statically significant for all treatment schemes. All patients with drug induced QT prolongation corrected the QT interval following the indications of the protocol, and no patients died of arrhythmic causes after its implementation. In our experience, a protocol for the electrocardiographic monitoring of these patients minimizes the risk of iatrogenic QT interval prolongation and consequently reduces sudden death events, and for that purpose, portable devices like the one used in this protocol may constitute a useful tool to minimize the contact with such patients.

Keywords: Azithromycin; COVID-19; Hydroxychloroquine; Portable device; QT interval; SARS-CoV-2.

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Conflict of interest statement

The authors report no relationships that could be construed as a conflict of interest.

Figures

Fig. 1
Fig. 1
Electrocardiographic monitoring protocol with KardiaMobile® in patients with COVID-19 treated with drugs with a known risk for prolonging the QTc interval.
Fig. 2
Fig. 2
Changes in QTc during the treatment with different drugs for COVID-19. AZT: azithromycin, HCQ: hydroxychloroquine, Lop/Rit: lopinavir and ritonavir.
See this image and copyright information in PMC

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