Wide complex tachycardia in a COVID-19 patient: What is the mechanism?

Reddy, Vivek; Reddy, Vickram; Mangat, Satwant; Shokr, Mohamed; Kundumadam, Shanker; Laharwani, Hansini

doi:10.1016/j.jelectrocard.2020.05.001

Cited by 6 publications

(6 citation statements)

References 2 publications

(2 reference statements)

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“…In some studies, STEMI has been reported in some COVID-19 patients. 16 In our study, STEMI was detected in 4.8% of the patients with COVID-19 while it was not observed in any of the patients in the control group. Since there was no significant difference between the two groups, it can be concluded that ST-segment elevation is not a characteristic ECG finding for COVID-19.…”

Section: Discussioncontrasting

confidence: 46%

Characteristic Electrocardiography Findings of COVID-19 Patients

Gür

Ulutaş

2021

Arch Iran Med

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Background: Determining a relationship between coronavirus disease 2019 (COVID-19) and the ECG findings of the patients with this disease can assist in early diagnosis and patient management based on these findings. This study aimed to investigate whether COVID-19 patients had characteristic ECG findings in the acute period. Methods: A total of 124 patients were divided into two groups as those diagnosed with COVID-19 and controls. The ECGs of these patients were evaluated in terms of rate, rhythm, presence of ST changes, PR interval, QRS width, QTc and QT interval, and presence of right and left bundle branch blocks. Results: On the ECG, the median heart rate of the COVID-19 patients was 104/min (IQR: 99–114), and there was a significant difference compared to the control group (P<0.001). The median PR interval was 157/ms, the QRS width was 86 ± 9/ms in the COVID-19 patients, with no significant difference compared to the controls (P = 0.161 and P = 0.631, respectively). The median QT interval of the COVID-19 patients was normal (400/ms), but a significant difference was detected compared to the controls (P = 0.005). The QTc, ST change, AF, and presence of right and left bundle branch blocks were not significantly different between the two groups. Conclusion: Considering the importance of ECG findings in order to diagnose COVID-19 disease early, we can state that sinus tachycardia is very common in COVID-19 patients, but there is no characteristic ECG finding for COVID-19, including tachycardia.

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Section: Discussioncontrasting

confidence: 46%

Characteristic Electrocardiography Findings of COVID-19 Patients

Gür

Ulutaş

2021

Arch Iran Med

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“…A case of a transient complete heart block in a 54-year-old man with critical COVID-19 was recently reported [ 14 ]. Atrial tachycardia or atypical atrial flutter with 2:1 conduction and a concomitant wide QRS morphology in a COVID-19 positive patient was also reported [ 15 ].…”

Section: Covid-19 and Markers Of Myocardial Damagementioning

confidence: 99%

Value of electrocardiography in coronavirus disease 2019 (COVID-19)

Haseeb

Gül

Çinier

et al. 2020

Journal of Electrocardiology

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In December 2019, reports of an unknown pneumonia not responsive to traditional treatments arose in Wuhan, China. The pathogen was subsequently identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known to be responsible for the coronavirus disease-2019 (COVID-19) illness, and public health emergency of international concern was declared by the World Health Organization. There is increasing awareness of the cardiovascular manifestations of COVID-19 disease, and the adverse impact of cardiovascular involvement on its prognosis. In this setting, the electrocardiogram (ECG) is one of the leading tools to assess the extent of cardiac involvement in COVID-19 patients, due to its wide disponibility, low cost, and the possibility of remote evaluation. In this article, we review the role of the ECG in the identification of cardiac involvement in COVID-19, highlighting relevant clinical implications.

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“…In SVT with LBBB morphology due to aberrant conduction, the QRS complex in lead V1 exhibits a narrow (<30 msec) initial R wave and a sharp, smooth descent (Figure 5A ). 28 Notching in the downslope of the S wave in lead V1 and/or V2 and an interval from the onset of the QRS complex to the nadir of the S wave >60 mseconds suggests a diagnosis of VT (Figure 5B ), an observation initially made by Josephson, et al 29 , 30 These findings are more likely to be observed in patients with previous anterior wall infarction.…”

Section: Electrocardiographic Featuresmentioning

confidence: 78%

Differential diagnosis of wide QRS tachycardia: A review

Abedin

2021

Journal of Arrhythmia

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Differential diagnosis of wide QRS tachycardia (WQRST) on the electrocardiogram remains a challenging exercise. Correct diagnosis is important for prescribing appropriate therapy and determining prognosis. Differential diagnosis of wide QRS tachycardia revolves around differentiation between supraventricular tachycardia with aberrant conduction and ventricular tachycardia. Observations such as clinical history, findings of physical examination during tachycardia, AV dissociation, QRS morphology in lead V1 and lead V6, precordial concordance, RS complexes in precordial leads, contralateral bundle branch block during wide QRS tachycardia, R wave morphologies in lead aVR, and ventricular initial/terminal velocity of conduction ratio can help arrive at the correct diagnosis with reasonable accuracy. The observations described here can help arrive at the correct diagnosis of WQRST with both reasonable accuracy and confidence.

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Wide complex tachycardia in a COVID-19 patient: What is the mechanism?

Cited by 6 publications

References 2 publications

Characteristic Electrocardiography Findings of COVID-19 Patients

Characteristic Electrocardiography Findings of COVID-19 Patients

Value of electrocardiography in coronavirus disease 2019 (COVID-19)

Differential diagnosis of wide QRS tachycardia: A review

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