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Published on: December 11, 2019
QT Interval Monitoring with Handheld Heart Rhythm ECG Device in COVID-19 Patients
Carlos Minguito-Carazo1, Julio Echarte-Morales1, Tomás Benito-González1
1Department of Cardiology, University Hospital of León, León, ES.
Insights
QTc monitoring using a handheld KardiaMobile-6L device is feasible for COVID-19 patients. This smart device offers a faster ECG registration time, potentially reducing virus transmission risks.
Area of Science:
- Cardiology
- Infectious Diseases
- Digital Health
Background:
- QTc prolongation is a known adverse effect of certain COVID-19 therapies.
- The utility of handheld ECG devices for monitoring QTc in these patients remains unaddressed.
Purpose of the Study:
- To assess the feasibility of using a smart device (KardiaMobile-6L) for QTc interval monitoring in COVID-19 patients undergoing treatment with QTc-interfering medications.
Main Methods:
- A prospective study involved COVID-19 patients receiving hydroxychloroquine, azithromycin, or lopinavir-ritonavir.
- ECG monitoring was conducted using either a 12-lead ECG or the KardiaMobile-6L device.
- QTc prolongation was compared across three monitoring strategies, and ECG acquisition time was recorded.
Main Results:
- No significant differences in QTc prolongation were observed between the 12-lead ECG and KardiaMobile-6L monitoring strategies.
- The smart device demonstrated moderate reliability for QTc measurement in healthy controls.
- ECG registration time was significantly shorter with the handheld device compared to the 12-lead ECG.
Conclusions:
- QTc monitoring with the KardiaMobile-6L is feasible in COVID-19 patients.
- The reduced time for ECG acquisition with the smart device may aid in preventing viral dissemination among healthcare providers.
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.
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