Key result
A 71-year-old male with suspected COVID-19 developed a new onset, irreversible, prolonged QT-interval and high-degree AV block that was successfully managed with a permanent biventricular pacemaker.
Why the study?
There are a limited number of reports of irreversible QT-prolongation associated with COVID-19.
Case Report (n=1)
No
Highlights a potential association between COVID-19 systemic inflammation and irreversible QT-prolongation requiring pacing, emphasizing clinical judgment over negative RT-PCR testing.
Raises possibility of permanent pacing for COVID-19 conduction disease; hypothesis-generating and should not yet change practice.
Various electrocardiographic (EKG) manifestations have been reported in patients with coronavirus disease 2019 (COVID-19). There is growing evidence showing that new onset QT-prolongation is a common EKG finding in COVID-19 patients. In this report, we present a case of a 71-year-old man who was found to have a new onset, irreversible, prolonged QT-interval requiring permanent biventricular pacemaker despite testing negative twice for RT-PCR COVID-19 and correction of all known reversible causes. To date, there are a limited number of reports of irreversible QT-prolongation associated with COVID-19. This case report emphasizes the importance of a physician's clinical judgment in the setting of negative RT-PCR COVID-19 testing. A robust systemic inflammatory state seen in active COVID-19 infection is possibly the key mechanism precipitating the new EKG findings.
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Jallad et al. (2021) conducted a case report in Prolonged QT-interval and high-degree AV block in suspected COVID-19 (n=1). Biventricular pacemaker implantation was evaluated on Shortening of QT interval and hemodynamic stability. A 71-year-old male with suspected COVID-19 developed a new onset, irreversible, prolonged QT-interval and high-degree AV block that was successfully managed with a permanent biventricular pacemaker.
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