QT Interval Monitoring with Handheld Heart Rhythm ECG Device in COVID-19 Patients

Glob Heart. 2021 Jun 8;16(1):42. doi: 10.5334/gh.916.

Abstract

Background: QTc prolongation is an adverse effect of COVID-19 therapies. The use of a handheld device in this scenario has not been addressed.

Objectives: To evaluate the feasibility of QTc monitoring with a smart device in COVID-19 patients receiving QTc-interfering therapies.

Methods: Prospective study of consecutive COVID-19 patients treated with hydroxychloroquine ± azithromycin ± lopinavir-ritonavir. ECG monitoring was performed with 12-lead ECG or with KardiaMobile-6L. Both registries were also sequentially obtained in a cohort of healthy patients. We evaluated differences in QTc in COVID-19 patients between three different monitoring strategies: 12-lead ECG at baseline and follow-up (A), 12-lead ECG at baseline and follow-up with the smart device (B), and fully monitored with handheld 6-lead ECG (group C). Time needed to obtain an ECG registry was also documented.

Results: One hundred and eighty-two COVID-19 patients were included (A: 119(65.4%); B: 50(27.5%); C: 13(7.1%). QTc peak during hospitalization did significantly increase in all groups. No differences were observed between the three monitoring strategies in QTc prolongation (p = 0.864). In the control group, all but one ECG registry with the smart device allowed QTc measurement and mean QTc did not differ between both techniques (p = 0.612), displaying a moderate reliability (ICC 0.56 [0.19-0.76]). Time of ECG registry was significantly longer for the 12-lead ECG than for handheld device in both cohorts (p < 0.001).

Conclusion: QTc monitoring with KardiaMobile-6L in COVID-19 patients was feasible. Time of ECG registration was significantly lower with the smart device, which may offer an important advantage for prevention of virus dissemination among healthcare providers.

Keywords: COVID-19; KardiaMobile-6L; QTc; handheld ECG; ventricular arrhythmia.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects
  • Antiviral Agents / adverse effects
  • Azithromycin / adverse effects
  • COVID-19 Drug Treatment*
  • Drug Combinations
  • Electrocardiography / instrumentation
  • Electrocardiography / methods*
  • Enzyme Inhibitors / adverse effects
  • Feasibility Studies
  • Female
  • Humans
  • Hydroxychloroquine / adverse effects
  • Long QT Syndrome / chemically induced
  • Long QT Syndrome / diagnosis*
  • Lopinavir / adverse effects
  • Male
  • Middle Aged
  • Point-of-Care Systems
  • Prospective Studies
  • Reproducibility of Results
  • Ritonavir / adverse effects
  • SARS-CoV-2

Substances

  • Anti-Bacterial Agents
  • Antiviral Agents
  • Drug Combinations
  • Enzyme Inhibitors
  • lopinavir-ritonavir drug combination
  • Lopinavir
  • Hydroxychloroquine
  • Azithromycin
  • Ritonavir