- Long QT Syndrome (LQTS) is an inheritable condition defined by abnormally long ventricular prolongation and a high risk of fatal arrhythmia like Torsades de Pointes and ventricular fibrillation.
- In patients with inherited or acquired prolonged QT, a major contributing factor in developing malignant arrythmias is the use of QTc prolonging drugs.
- Use of hydroxychloroquine in association with other anti-virals drugs may cause significant QT-prolongation.
- Fever does not in general affect patients with LQTS (except those with LQTS 2 mutations, that can develop fever-induced arrhythmia)
- For management recommendations:
- QTc-interval monitoring in patients with LQTS, acquired QT-prolongation or conditions associated with the latter (ie: QT-prolonging drugs, structural heart conditions, bradycardia, liver and renal disease)
- If QTc > 500 msec, a consultation with a cardiologist and reevaluation of potential QTc prolonging drugs is advised.
- Patients with acquired LQTS or under many QT-prolonging drugs should have high potassium levels (≥4,0).
This study describes the possible risks related to COVID-19 and treatment considerations for patients with the inherited arrhythmia syndromes, such as Long QT syndrome, Brugada syndrome, Short QT syndrome, and Catecholaminergic Polymorphic Ventricular Tachycardia. It also details recommendations for monitoring and managing of these patients during the COVID-19 pandemic.
Wu C-I, Postema PG, Arbelo E, Behr ER, Bezzina CR, Napolitano C, Robyns T, Probst V, Schulze-Bahr E, Remme CA, Wilde AAM, SARS-CoV-2, COVID-19 and inherited arrhythmia syndromes, Heart Rhythm (2020), https://doi.org/10.1016/j.hrthm.2020.03.024.