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Electrical storm in a patient with COVID-19 treated with hydroxychloroquine: A case report

Francesco Vetta1, Leonardo Marinaccio2, Giampaolo Vetta1

  • 1Saint Camillus International University of Health Sciences, Rome, Italy.

SAGE Open Medical Case Reports
|November 26, 2020
PubMed

Insights

Hydroxychloroquine (HCQ) may increase the risk of dangerous heart arrhythmias, including electrical storms, in COVID-19 patients. Discontinuing HCQ led to stabilization, highlighting the need for cardiac monitoring during treatment.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Hydroxychloroquine (HCQ) is frequently used for COVID-19 despite controversial efficacy and safety data.
  • Cardiac adverse events are known complications of HCQ therapy.
  • Electrical storm has not been previously reported in COVID-19 patients or those treated with HCQ.

Observation:

  • A 78-year-old male with COVID-19 and an implantable cardiac resynchronization defibrillator (CRT-D) developed an electrical storm.
  • The event occurred after several days of home therapy with HCQ.
  • The electrical storm correlated with a QTc interval increase.

Findings:

  • Discontinuation of HCQ in the intensive care unit resulted in QTc interval reduction.
  • Electrical stabilization was observed after HCQ was stopped.
  • This case suggests a link between HCQ use and the development of electrical storm.

Implications:

  • Highlights a potential risk of HCQ in precipitating serious cardiac arrhythmias.
  • Emphasizes the critical need for vigilant electrocardiographic monitoring in patients on HCQ.
  • Suggests particular caution in patients with pre-existing cardiac conditions or devices like CRT-D.

Keywords:
COVID-19Electrical stormQTc prolongationcase reporthydroxychloroquineventricular tachycardia

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