QT interval monitoring with handheld heart rhythm ECG device in COVID-19 patients.

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:underline>Objectives</jats:underline>: To evaluate the feasibility of QTc monitoring with a smart device in COVID-19 patients receiving QTc-interfering therapies.<jats:underline>Background</jats:underline>: QTc prolongation is an adverse effect of COVID-19 therapies. The use of a handheld device in this scenario has not been addressed.<jats:underline>Methods</jats:underline>: 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 3 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.<jats:underline>Results</jats:underline>: 182 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 3 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&lt;0.001).<jats:underline>Conclusion</jats:underline>: 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.</jats:p>

Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device

“…Furthermore, the global pandemic further complicated cardiology services as COVID-19 eventually emerged as an airborne disease, and physical distancing had been carried out to prevent the spread of infection. Therefore, attempts were made to use portable ECG devices to minimize exposure and disease transmission [18,35].…”

Home Monitoring of Cardiac Devices in the Era of COVID-19

“…There has been a push to produce safe, validated RPM tools for COVID-19 monitoring in the outpatient setting. The KardiaMobile-6L (AliveCor, Inc.) recently received FDA emergency clearance for QTc monitoring and was demonstrated as a feasible alternative to ECG QTc measurements in COVID-19 patients treated with hydroxychloroquine, lopinavir-ritonavir, and/or azithromycin [63], medications under investigation for treatment of COVID-19 at the time with known increased risk of QT prolongation particularly in combination [64,65]. The FDA has further provided emergency approval for multiple remote patient monitors to further enable the collection of physiologic data in this age of social distancing yet there remain major gaps in realizing a virtual healthcare model [66].…”