COVID-19 infection and cardiac arrhythmias
Antonis S Manolis1, Antonis A Manolis2, Theodora A Manolis3
1First Department of Cardiology, Athens University School of Medicine, Athens, Greece.
Insights
The COVID-19 pandemic increases cardiac arrhythmias due to viral effects and drug interactions. Contactless monitoring is crucial for managing QT prolongation and preventing sudden cardiac death.
Area of Science:
- Cardiology
- Infectious Diseases
- Digital Health
Background:
- COVID-19 (coronavirus disease 2019) is associated with increased cardiac arrhythmias.
- Viral effects on respiratory and cardiovascular systems, systemic inflammation, and drug interactions contribute to arrhythmogenicity.
- QT prolongation by COVID-19 pharmacotherapies can cause torsades de pointes and sudden cardiac death.
Purpose of the Study:
- To review the mechanisms of COVID-19-associated cardiac arrhythmias.
- To highlight the need for improved QT interval monitoring during COVID-19 treatment.
- To discuss the role of digital health and contactless monitoring solutions.
Main Methods:
- Review of recent scientific literature on COVID-19 and cardiac arrhythmias.
- Analysis of arrhythmogenic mechanisms, including drug effects and autonomic imbalance.
- Discussion of technological advancements in patient monitoring.
Main Results:
- COVID-19 patients face heightened risk of arrhythmias from viral and pharmacological factors.
- Conventional QT monitoring poses risks of transmission and strains healthcare systems.
- Digital health tools offer promising contactless monitoring solutions.
Conclusions:
- Effective management of COVID-19 requires vigilant monitoring of cardiac arrhythmias.
- Contactless monitoring and telemetry are essential for inpatients and outpatients.
- Technological innovations are vital for safe and efficient patient care during the pandemic.
Abstract:
As the coronavirus 2019 (COVID-19) pandemic marches unrelentingly, more patients with cardiac arrhythmias are emerging due to the effects of the virus on the respiratory and cardiovascular (CV) systems and the systemic inflammation that it incurs, and also as a result of the proarrhythmic effects of COVID-19 pharmacotherapies and other drug interactions and the associated autonomic imbalance that enhance arrhythmogenicity. The most worrisome of all arrhythmogenic mechanisms is the QT prolonging effect of various anti-COVID pharmacotherapies that can lead to polymorphic ventricular tachycardia in the form of torsade des pointes and sudden cardiac death. It is therefore imperative to monitor the QT interval during treatment; however, conventional approaches to such monitoring increase the transmission risk for the staff and strain the health system. Hence, there is dire need for contactless monitoring and telemetry for inpatients, especially those admitted to the intensive care unit, as well as for outpatients needing continued management. In this context, recent technological advances have ushered in a new era in implementing digital health monitoring tools that circumvent these obstacles. All these issues are herein discussed and a large body of recent relevant data are reviewed.
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