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Ventricular repolarization indexes in patients treated with hydroxychloroquine - azithromycin combination for

S Gunay, S Caliskan, D Sigirli

    Bratislavske Lekarske Listy
    |November 9, 2020
    PubMed

    Insights

    Hydroxychloroquine and azithromycin combination for COVID-19 increased cardiac arrhythmia risk. Ventricular repolarization indexes, not just QTc, are key indicators for monitoring potential arrhythmias in patients.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Infectious Diseases

    Background:

    • The combination of hydroxychloroquine and azithromycin for COVID-19 treatment is associated with an elevated risk of corrected QT (QTc) prolongation and cardiac arrhythmias.
    • Understanding the specific electrocardiographic changes related to this drug combination is crucial for patient safety.

    Purpose of the Study:

    • To identify ventricular repolarization indexes linked to malignant ventricular arrhythmias in COVID-19 patients receiving hydroxychloroquine and azithromycin.
    • To evaluate the utility of specific repolarization indexes beyond QTc interval in assessing arrhythmia risk.

    Main Methods:

    • Retrospective analysis of electrocardiograms from 81 patients treated with hydroxychloroquine and azithromycin for COVID-19.
    • Calculation and comparison of ventricular repolarization indexes, including Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios, before and after treatment.

    Main Results:

    • No significant increase in the QTc interval was observed in patients receiving the combination therapy.
    • A significant increase in ventricular repolarization indexes (Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios) was noted.

    Conclusions:

    • Increased ventricular repolarization indexes are associated with a higher risk of cardiac arrhythmias.
    • QTc interval monitoring alone may be insufficient for arrhythmia surveillance in patients on QTc-prolonging COVID-19 treatments.
    • Elevated ventricular repolarization indexes can indicate arrhythmia risk even without QTc prolongation.
    Abstract

    Keywords:
    QTc prolongationTp-eazithromycinhydroxychloroquinerepolarization arrhythmia.

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