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