Telemedicine-based early rule out electrocardiography algorithm:Hydroxychloroquine in COVID-19 patients


TURAN O. E., YILANCIOĞLU R. Y., ALAK Ç., BAŞKURT A. A., DUĞRAL E., ÖZGEN ALPAYDIN A., ...Daha Fazla

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, cilt.35, sa.3, ss.227-236, 2021 (Hakemli Dergi) identifier

Özet

Objective: Drugs with the potential to prolong QT are used in the treatment of coronavirus 19 (COVID-19) pneumonia. We have developed a telemedicinebased corrected QT (QTc) follow-up algorithm that allows early rule out for follow up. In this study, we investigated the availability and safety of the algorithm. Materials and Methods: Consecutive patients; administered hydroxychloroquine (HCQ) for COVID-19 pneumonia were enrolled into digital ECG recording program which includes QTc follow-up algorithm. Results: Patients were classified into three groups as follows: Those excluded promptly from the QTc follow-up based on two consecutive ECG findings (early rule out, n=92) and those for whom the follow-up was continued (n=12) and the usual care group (n=68). Of note, 237 ECG tracings were performed in our algorithm population contrary to standard practice of daily-recommended ECG monitoring which could have yielded 975 ECG tracings along with accompanied risks of exposure. This way; we ended in 738 (75.7%) fewer ECG tracings. Sustained ventricular arrhythmia or sudden cardiac death was not observed in the entire patient population. Conclusion: It is safe to rely on telemedicine-based early rule out algorithm in COVID-19 patients, receiving hydroxychloroquine treatment. This algorithm abolished the need for further ECG in majority of patients without increased risk during follow up. These algorithms can significantly reduce the healthcare worker exposures by eliminating the need for ECG follow-up promptly.