Saudi Heart Rhythm Society Task Force on Management of Potential Arrhythmogenicity Associated with Pharmacotherapy for COVID-19

Ann Saudi Med. 2020 Sep-Oct;40(5):365-372. doi: 10.5144/0256-4947.2020.365. Epub 2020 Oct 1.

Abstract

Evidence of cardiovascular complications associated with the COVID-19 global pandemic continues to evolve. These include direct and indirect myocardial injury with subsequent acute myocardial ischemia, and cardiac arrhythmia. Some results from a limited number of trials of antiviral medications, along with chloroquine/hydroxychloroquine and azithromycin, have been beneficial. However, these pharmacotherapies may cause drug-induced QT prolongation leading to ventricular arrhythmias and sudden cardiac death. Mitigation of the potential risk in these susceptible patients may prove exceptionally challenging. The Saudi Heart Rhythm Society established a task force to perform a review of this subject based on has recently published reports, and studies and recommendations from major medical organizations. The objective of this review is to identify high-risk patients, and to set clear guidelines for management of patients receiving these pharmacotherapies.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Advisory Committees
  • Antiviral Agents / adverse effects
  • Arrhythmias, Cardiac / chemically induced*
  • Arrhythmias, Cardiac / diagnosis
  • Azithromycin / adverse effects
  • Betacoronavirus
  • COVID-19
  • COVID-19 Drug Treatment
  • Chloroquine / adverse effects
  • Coronavirus Infections / drug therapy*
  • Cytochrome P-450 CYP2D6 Inhibitors / adverse effects
  • Drug Combinations
  • Drug Interactions
  • Drug Monitoring
  • Electrocardiography
  • Humans
  • Hydroxychloroquine / adverse effects
  • Long QT Syndrome / chemically induced
  • Long QT Syndrome / diagnosis
  • Lopinavir / adverse effects
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Risk Assessment
  • Ritonavir / adverse effects
  • SARS-CoV-2
  • Saudi Arabia
  • Torsades de Pointes / chemically induced
  • Torsades de Pointes / diagnosis

Substances

  • Adrenergic beta-Antagonists
  • Antiviral Agents
  • Cytochrome P-450 CYP2D6 Inhibitors
  • Drug Combinations
  • lopinavir-ritonavir drug combination
  • Lopinavir
  • Hydroxychloroquine
  • Azithromycin
  • Chloroquine
  • Ritonavir

Grants and funding

None.