Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart); Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart).
Heart Rhythm. 2020 Sep;17(9):1456-1462. doi: 10.1016/j.hrthm.2020.03.024. Epub 2020 Mar 31.
Ever since the first case was reported at the end of 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated coronavirus disease 2019 (COVID-19) has become a serious threat to public health globally in short time. At this point in time, there is no proven effective therapy. The interactions with concomitant disease are largely unknown, and that may be particularly pertinent to inherited arrhythmia syndrome. An arrhythmogenic effect of COVID-19 can be expected, potentially contributing to disease outcome. This may be of importance for patients with an increased risk of cardiac arrhythmias, either secondary to acquired conditions or comorbidities or consequent to inherited syndromes. Management of patients with inherited arrhythmia syndromes such as long QT syndrome, Brugada syndrome, short QT syndrome, and catecholaminergic polymorphic ventricular tachycardia in the setting of the COVID-19 pandemic may prove particularly challenging. Depending on the inherited defect involved, these patients may be susceptible to proarrhythmic effects of COVID-19-related issues such as fever, stress, electrolyte disturbances, and use of antiviral drugs. Here, we describe the potential COVID-19-associated risks and therapeutic considerations for patients with distinct inherited arrhythmia syndromes and provide recommendations, pending local possibilities, for their monitoring and management during this pandemic.
自 2019 年底首例病例报告以来,严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)和相关的 2019 年冠状病毒病(COVID-19)在短时间内已成为全球公共卫生的严重威胁。在现阶段,尚无经证实有效的治疗方法。与伴随疾病的相互作用在很大程度上尚不清楚,这可能与遗传性心律失常综合征特别相关。预计 COVID-19 会产生致心律失常作用,可能会影响疾病的结果。这对于因获得性疾病或合并症或遗传性综合征而增加发生心律失常风险的患者可能很重要。在 COVID-19 大流行期间,管理长 QT 综合征、Brugada 综合征、短 QT 综合征和儿茶酚胺敏感性多形性室性心动过速等遗传性心律失常综合征的患者可能会特别具有挑战性。根据所涉及的遗传缺陷,这些患者可能容易受到 COVID-19 相关问题(如发热、压力、电解质紊乱和使用抗病毒药物)的致心律失常作用的影响。在这里,我们描述了 COVID-19 相关风险和治疗注意事项,适用于不同遗传性心律失常综合征的患者,并根据当地情况,提出了在大流行期间监测和管理这些患者的建议。