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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
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An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Prolonged QT predicts prognosis in COVID-19.

Zaki Akhtar1,2, Mark M Gallagher1,2, Yee Guan Yap3

  • 1Department of Cardiology, Ashford and St Peter's NHS trust, Chertsey, Surrey, UK.

Pacing and Clinical Electrophysiology : PACE
|April 1, 2021
PubMed
Summary

Coronavirus disease-2019 (COVID-19) illness can cause corrected QT interval (QTc) prolongation. This QTc prolongation is linked to increased mortality risk in COVID-19 patients.

Keywords:
COVID-19Sars-Cov-2electrocardiogrammortalityprolonged QTc

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease-2019 (COVID-19) is a severe illness causing multi-organ dysfunction.
  • Abnormal electrocardiograms, including QT prolongation, are associated with poor outcomes in COVID-19 patients.
  • QT prolongation in COVID-19 has been previously linked to pharmacological effects.

Purpose of the Study:

  • To investigate the effects of COVID-19 illness on the corrected QT interval (QTc).
  • To determine if QTc prolongation is associated with mortality in COVID-19 patients.

Main Methods:

  • A retrospective study of 293 consecutive COVID-19 patients admitted to the hospital.
  • Comparison of demographic data, laboratory findings, and electrocardiograms between survivors and non-survivors.
  • Multivariate Cox-regression analysis to identify predictors of mortality.

Main Results:

  • Deceased patients were older and had higher levels of C-reactive protein and troponin.
  • A significantly longer QTc interval was observed in non-survivors compared to survivors (461.1 ms vs 449.3 ms).
  • QTc prolongation (>455 ms for males, >465 ms for females) was a significant predictor of mortality (HR 1.49).

Conclusions:

  • QTc prolongation occurs during COVID-19 illness.
  • QTc prolongation is associated with increased mortality risk in COVID-19 patients.
  • Monitoring QTc interval may aid in risk stratification for severe COVID-19 outcomes.