American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2021, 9(4), 249-252
DOI: 10.12691/ajmcr-9-4-11
Open AccessCase Report

New Onset, Irreversible, Prolonged QT-Interval Requiring Permanent Biventricular Pacemaker in a COVID-19 Patient

Ahmad Jallad1, Andrew V. Doodnauth2, Justin Lee1, Emmanuel Valery2, Stephanie Myers2, Dahlia Rizk3 and Samy I. McFarlane2,

1Division of Cardiovascular Medicine, Electrophysiology Section, State University of New York: Downstate Medical Center, Brooklyn, New York, United States- 11203

2Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States- 11203

3Division of Hospital Medicine, Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine NY, NY 10003

Pub. Date: February 03, 2021

Cite this paper:
Ahmad Jallad, Andrew V. Doodnauth, Justin Lee, Emmanuel Valery, Stephanie Myers, Dahlia Rizk and Samy I. McFarlane. New Onset, Irreversible, Prolonged QT-Interval Requiring Permanent Biventricular Pacemaker in a COVID-19 Patient. American Journal of Medical Case Reports. 2021; 9(4):249-252. doi: 10.12691/ajmcr-9-4-11

Abstract

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.

Keywords:
QT-prolongation coronavirus disease 2019 RT-PCR COVID-19 cardiac pacemaker

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Kochav SM, Coromilas E, Nalbandian A, Ranard LS, Gupta A, Chung MK, Gopinathannair R, Biviano AB, Garan H, Wan EY. Cardiac Arrhythmias in COVID-19 Infection. Circ Arrhythm Electrophysiol. 2020 Jun; 13(6): e008719.
 
[2]  Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, Brown TS, Der Nigoghossian C, Zidar DA, Haythe J, Brodie D, Beckman JA, Kirtane AJ, Stone GW, Krumholz HM, Parikh SA. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. J Am Coll Cardiol. 2020 May 12; 75(18): 2352-2371.
 
[3]  Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; 323(11): 1061-1069.
 
[4]  Ai T, Yang Z, Hou H, et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology 2020; 200642.
 
[5]  World Health Organization. Coronavirus disease (COVID-19) technical guidance: Surveillance and case definitions. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus- 2019/technical-guidance/surveillance-and-case-definitions. Accessed February 28, 2020
 
[6]  Xie X, Zhong Z, Zhao W, et al. Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing. Radiology 2020; 200343.
 
[7]  Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. J Am Coll Cardiol 2018; 74(7): 51-156.
 
[8]  Levine E, Rosero SZ, Budzikowski AS, Moss AJ, Zareba W, Daubert JP. Congenital long QT syndrome: considerations for primary care physicians. Cleve Clin J Med. 2008; 75(8): 591-600.
 
[9]  Daubert JP, Zareba W, Rosero SZ, Budzikowski A, Robinson JL, Moss AJ. Role of implantable cardioverter defibrillator therapy in patients with long QT syndrome. Am Heart J. 2007; 153(4 Suppl): 53-58.
 
[10]  Anne B. Curtis, M.D Biventricular versus Right Ventricular Pacing in Heart Failure Patients with Atrioventricular Block (BLOCK HF) Trial Investigators, N Engl J Med 2013; 368: 1585-93.
 
[11]  Bamimore A, Budzikowski AS. The demise of Bazett's formula?. Cardiology. 2012; 122(1): 1-2.