Key result
Handheld 6-lead ECG matches standard 12-lead for QTc monitoring while cutting registration time.
Why the study?
QTc prolongation is an adverse effect of COVID-19 therapies, but the use of a handheld device for QTc monitoring in this setting had not been addressed.
Does QTc monitoring with a handheld 6-lead ECG device provide comparable QTc measurements and reduce registration time compared to 12-lead ECG in COVID-19 patients?
Observational (n=182)
No
Does QTc monitoring with a handheld 6-lead ECG device provide comparable QTc measurements and reduce registration time compared to 12-lead ECG in COVID-19 patients?
Absolute Event Rate: 23.8% vs 25.3%
p-value: p=0.864
Handheld 6-lead ECG devices offer a feasible and faster alternative to standard 12-lead ECGs for QTc monitoring in COVID-19 patients, potentially reducing healthcare worker exposure.
May support time-efficient QTc monitoring with handheld devices in COVID-19; leaves open need for randomized validation before wider use.
Background: QTc prolongation is an adverse effect of COVID-19 therapies. The use of a handheld device in this scenario has not been addressed. Objectives: To evaluate the feasibility of QTc monitoring with a smart device in COVID-19 patients receiving QTc-interfering therapies. Methods: 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 three 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. Results: One hundred and eighty-two 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 three 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 < 0.001). Conclusion: 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.
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Minguito‐Carazo et al. (2021) conducted an observational in COVID-19 (n=182). KardiaMobile-6L handheld ECG device vs. Conventional 12-lead ECG was evaluated on QTc change from baseline (p=0.864). QTc monitoring with a 6-lead handheld ECG device in COVID-19 patients receiving QTc-prolonging therapies showed no significant difference in QTc prolongation compared to conventional 12-lead ECG (p=0.864), while significantly reducing ECG registration time.