Behavior of the PR interval with increasing heart rate in patients with COVID-19.
Heart Rhythm
; 17(9): 1434-1438, 2020 09.
Article
in English
| MEDLINE | ID: covidwho-593448
ABSTRACT
BACKGROUND:
Myriad manifestations of cardiovascular involvement have been described in patients with coronavirus disease 2019 (COVID-19), but there have been no reports of COVID-19 affecting the cardiac conduction system. The PR interval on the electrocardiogram (ECG) normally shortens with increasing heart rate (HR). The case of a patient with COVID-19 manifesting Mobitz type 1 atrioventricular (AV) block that normalized as the patient's condition improved prompted us to investigate PR interval behavior in patients with COVID-19.OBJECTIVE:
The purpose of this study was to characterize PR interval behavior in hospitalized patients with COVID-19 and to correlate that behavior with clinical outcomes.METHODS:
This study was a cross-sectional cohort analysis of confirmed COVID-19 cases (March 26, 2020, to April 25, 2020). We reviewed pre-COVID-19 and COVID-19 ECGs to characterize AV conduction by calculating the PR interval to HR (PRHR) slope. Clinical endpoints were death or need for endotracheal intubation.RESULTS:
ECGs from 75 patients (246 pre-COVID-19 ECGs and 246 COVID-19 ECGs) were analyzed for PRHR slope. Of these patients, 38 (50.7%) showed the expected PR interval shortening with increasing HR (negative PRHR slope), whereas 37 (49.3%) showed either no change (8 with PRHR slope = 0) or paradoxical PR interval prolongation (29 with positive PRHR slope) with increasing HR. Patients without PR interval shortening were more likely to die (11/37 [29.7%] vs 3/38 [7.9%]; P = .019) or require endotracheal intubation (16/37 [43.2%] vs 8/38 [21.1%]; P = .05) compared to patients with PR interval shortening.CONCLUSION:
Half of patients with COVID-19 showed abnormal PR interval behavior (paradoxical prolongation or lack of shortening) with increasing HR. This finding was associated with increased risk of death and need for endotracheal intubation.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Arrhythmias, Cardiac
/
Coronavirus Infections
/
Betacoronavirus
/
Heart Conduction System
/
Heart Rate
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Heart Rhythm
Year:
2020
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS