eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-02-03 9 4 249 252 10.12691/ajmcr-9-4-11 AJMCR20219411 article Ahmad Jallad 1 Andrew V. Doodnauth 2 Justin Lee 2 Emmanuel Valery 2 Stephanie Myers 2 Dahlia Rizk 3 Samy I. McFarlane Smcfarlane@downstte.edu 3 Division of Cardiovascular Medicine, Electrophysiology Section, State University of New York: Downstate Medical Center, Brooklyn, New York, United States- 11203 Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States- 11203 Division of Hospital Medicine, Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine NY, NY 10003 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. http://pubs.sciepub.com/ajmcr/9/4/11/ajmcr-9-4-11.pdf QT-prolongation coronavirus disease 2019 RT-PCR COVID-19 cardiac pacemaker