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COVID-19 infection and cardiac arrhythmias

机译:Covid-19感染和心脏心律失常

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As the coronavirus 2019 (COVID-19) pandemic marches unrelentingly, more patients with cardiac arrhythmias are emerging due to the effects of the virus on the respiratory and cardiovascular (CV) systems and the systemic inflammation that it incurs, and also as a result of the proarrhythmic effects of COVID-19 pharmacotherapies and other drug interactions and the associated autonomic imbalance that enhance arrhythmogenicity. The most worrisome of all arrhythmogenic mechanisms is the QT prolonging effect of various anti-COVID pharmacotherapies that can lead to polymorphic ventricular tachycardia in the form of torsade des pointes and sudden cardiac death. It is therefore imperative to monitor the QT interval during treatment; however, conventional approaches to such monitoring increase the transmission risk for the staff and strain the health system. Hence, there is dire need for contactless monitoring and telemetry for inpatients, especially those admitted to the intensive care unit, as well as for outpatients needing continued management. In this context, recent technological advances have ushered in a new era in implementing digital health monitoring tools that circumvent these obstacles. All these issues are herein discussed and a large body of recent relevant data are reviewed. (C) 2020 Elsevier Inc. All rights reserved.
机译:随着2019年冠状病毒(COVID-19)大流行的无情推进,由于该病毒对呼吸和心血管(CV)系统及其引起的全身炎症的影响,越来越多的心律失常患者正在出现,2019冠状病毒疾病的药物治疗和其他药物相互作用以及增强心律失常的相关自主神经失衡的结果。在所有致心律失常机制中,最令人担忧的是各种抗新冠病毒药物疗法的QT间期延长效应,它可能导致尖端扭转型室性心动过速和心源性猝死。因此,必须在治疗期间监测QT间期;然而,这种监测的传统方法增加了工作人员的传播风险,并给卫生系统带来压力。因此,迫切需要对住院患者,尤其是重症监护病房的住院患者,以及需要持续管理的门诊患者进行非接触式监测和遥测。在这种背景下,最新的技术进步开启了一个新时代,实现了绕过这些障碍的数字健康监测工具。本文讨论了所有这些问题,并回顾了大量近期相关数据。(C) 2020爱思唯尔公司版权所有。

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