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

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.

Heart Block in the Patients with COVID-19

“…Additional ECG findings reported in the included studies are sinus bradycardia 19 , sinus tachycardia 26 , sinus pauses in 3 patients 16 , and QT prolongation 24,32,37,40 .…”

“…Additional ECG findings reported in the included studies are sinus bradycardia 19 , sinus tachycardia 26 , sinus pauses in 3 patients 16 , and QT prolongation 24,32,37,40 . Pathophysiological, histological, and imaging data 8,43 indicate that SARS-CoV-2 could induce tissue damage, which would predispose patients to recurrent cardiac issues long-term after discharge.…”