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Cardiologists monitor heart rhythms of COVID-19 patients

April 30, 2020

Washington University cardiologists at Barnes-Jewish Hospital have developed a streamlined way for clinicians to monitor the heart rhythms of COVID-19 patients by remote telemetry.

Many of the drugs being investigated to treat the novel coronavirus have been associated with dangerous arrhythmias. According to cardiologist Phillip Cuculich, MD, a remote method to monitor heart rhythms could improve care for patients and protect health-care workers from the additional exposure that would result when conducting repeated electrocardiograms (ECGs).

Several of the drugs being given to patients with COVID-19, including chloroquine, hydroxychloroquine and azithromycin, are associated with a dangerous cardiac side effect called a long QT interval. The QT interval is the time it takes for the electrical system of the heart to recharge before the next beat. When the QT interval becomes too long, it can lead to a life-threatening arrhythmia called ventricular fibrillation, which causes cardiac arrest.

“This automated QT-interval screening tool will make it easier for physicians to identify high-risk patients before prescribing these drugs and throughout the treatment,” Cuculich said. “Ultimately, this helps patients and simplifies the doctors’, nurses’ and technicians’ jobs by simply leveraging advanced technologies in cardiac monitoring and integrated digital care here at Barnes-Jewish Hospital.”

The new workflow was led by Cuculich, Richard Bach, MD, and Marye Gleva, MD, in collaboration with the ICU and hospitalist teams at BJH. It integrates the Philips bedside monitors, cardiac telemetry capabilities, the EPIC electronic medical record system, and the e-ICU at the BJC Learning Institute.

“By doing this remotely, we can dramatically reduce exposure to the virus for technologists who otherwise would have to do ECGs several times per day,” said Cuculich.

Added Michael Lin, MD, interim chief of hospital medicine at BJH: “This process is on the mark for every key element — it greatly improves patient care and safety, is simple for the user, minimizes personnel exposure and supports PPE (personalized protective equipment) stewardship.”