Global Heart (Jun 2021)

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

  • Carlos Minguito-Carazo,
  • Julio Echarte-Morales,
  • Tomás Benito-González,
  • Samuel del Castillo-García,
  • Miguel Rodríguez-Santamarta,
  • Enrique Sánchez-Muñoz,
  • Clea González Maniega,
  • Rubén García-Bergel,
  • Paula Menéndez-Suárez,
  • Silvia Prieto-González,
  • Carmen Palacios-Echavarren,
  • Javier Borrego-Rodríguez,
  • Guisela Flores-Vergara,
  • Ignacio Iglesias-Garriz,
  • Felipe Fernández-Vázquez

DOI
https://doi.org/10.5334/gh.916
Journal volume & issue
Vol. 16, no. 1

Abstract

Read online

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