Genetic Heart Rhythm Diseases

Welcome to the Genetic Heart Rhythm Diseases page. The Mayo Clinic Windland Smith Rice Genetic Heart Rhythm Clinic, with the Windland Smith Rice Sudden Death Genomics Laboratory in Rochester, MN, is dedicated to diagnosing, treating, and researching all types of genetic heart rhythm diseases that can cause sudden death.

Follow the Genetic Heart Rhythm Diseases page and stay up-to-date as we post stories, clinical trials, and useful information regarding your genetic heart rhythm condition.

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COVID-19

Patients with Genetic Heart Disease and COVID-19

In these uncertain times, we at the Windland Smith Rice Genetic Heart Rhythm Clinic understand that everyone is worried about the SARS-Cov-2 (coronavirus)-caused COVID-19 and whether it puts patients with genetic heart disease at a higher risk. The following information is meant to provide some guidance for you during this difficult time. This is a rapidly changing situation and we will attempt to keep this information as up-to-date as possible.

FAQs for patients with genetic heart rhythm conditions:

First and foremost, all patients should follow relevant government advice on COVID-19. 

Current government guidelines and government-provided information can be found here:

Mayo Clinic has also set up a website to provide information about COVID-19. If you or a family member has an upcoming appointment, please check Mayo Clinic's Appointment and Visitor Restrictions page for more information as your visit may be rescheduled or changed to a non-face to face visit via either a teleconference or video consult.

It is important for everyone to monitor for symptoms of COVID-19. According to the CDC, symptoms may appear 2-14 days after exposure and usually include:

  • Fever
  • Cough
  • Shortness of breath

Of course, these symptoms are not always a sign of concern as these can indicate anything from a common cold to the seasonal flu. If you or one of your family members has a genetic heart rhythm disorder and is believed to have been exposed to the coronavirus and develop symptoms, contact your healthcare provider or local COVID-hotline (if available) right away for medical advice.

WhentoSeekMedicalAttention_COVID-19

Source: www.cdc.gov

COVID-19 and Genetic Heart Rhythm Disorders

We have been receiving many great questions from our patients regarding genetic heart rhythm disorders and COVID-19. We will address some of the most common questions below.

Most importantly, patients with genetic heart rhythm disorders (like LQTS, BrS, and CPVT) are not at higher risk of infection than anyone else. However, certain genetic heart muscle disorders (like ACM, DCM, and HCM) can be at increased risk of complications from COVID-19.

All patients, independent of their underlying heart rhythm disorder, should be cautious and practice proper handwashing and physical distancing (the 6-foot rule).

According to the Association for Inherited Cardiac Conditions (AICC), patients with genetic heart muscle disorders that are at an increased risk of complications once infected with COVID-19 are1:

  1. Dilated (DCM), arrhythmogenic (ACM), and hypertrophic (HCM) cardiomyopathy patients with LV impairment and/or symptomatic left heart failure.
  2. Arrhythmogenic cardiomyopathy (ACM) patients with RV impairment and/or symptomatic right heart failure.
  3. Symptomatic hypertrophic cardiomyopathy (HCM) with or without significant obstruction.

Patients with these disorders should obey strict physical distancing and should keep their social contacts to a minimum (family only if possible) to reduce the chance of contracting the virus.

Although we are not suggesting strict self-isolation for patients with Brugada syndrome (BrS), Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT), or long QT syndrome (LQTS), it is important to remember to follow the LQTS and BrS preventative measures if you do become ill. Because COVID-19 causes fever, it is especially important to aggressively treat fever (with acetaminophen) and persistently replace fluids and electrolytes. This is because fever increases the risk of arrhythmias in patients with these conditions.

For any patient with LQTS, the top 5 overarching preventative measures should always be observed:

  1. Avoidance of QT-prolonging medications whenever possible (www.crediblemeds.org or www.qtdrugs.org)
  2. Hydration and electrolyte replenishment, especially in the setting of vomiting and diarrheal illnesses
  3. Fever reduction in the setting of febrile illnesses and heat exhaustion avoidance
  4. Omega-3 fish oil supplementation as an optional supplement
  5. Learn CPR and obtain AED as part of a family's safety gear

For any patient with Brugada syndrome, the top 5 overarching preventative measures should always be observed:

  1. Avoidance of Brugada-aggravating medications (www.brugadadrugs.org)
  2. Hydration and electrolyte replenishment, especially in the setting of vomiting and diarrheal illnesses
  3. Fever reduction in the setting of febrile illnesses and heat exhaustion avoidance
  4. Avoidance of excess alcohol
  5. Strict avoidance of marijuana and cocaine

If you become ill and require medication and/or hospitalization, you must remember to tell your physicians and nurses that you have a genetic heart rhythm disorder. Work diligently with your physician to decide what the best course of action is for you. DO NOT STOP TAKING ANY MEDICATIONS WITHOUT THE DIRECTION OF YOUR PHYSICIAN!

Several antibiotics and antiviral medications are listed as QT-prolonging drugs and can increase the risk of arrhythmias. Furthermore, hydroxychloroquine and azithromycin have been suggested as possible treatments in the fight against the virus that causes COVID-19. We recommend any patient who is prescribed these medications to obtain or find their most recent QTc value (by 12-lead ECG, telemetry, or by smartphone-enabled mobile ECG devices).  These therapies are potentially dangerous to patients with LQTS but not necessarily to patients with any of the other genetic heart conditions unless they have an elevated QTc. For patients with minor symptoms, we suggest it best to skip these medications. PLEASE DO NOT SELF-MEDICATE WITH CHLOROQUINE, HYDROXYCHLOROQUINE, OR AZITHROMYCIN. 

For more information, please check out the possible COVID-19 therapies and the QTc algorithm and scientific paper with Dr. Ackerman as the senior author below.

2020-COVID19 Algorithm

What Dr. Ackerman is saying:

During recent weeks, Dr. Ackerman has been at the forefront of the discussion about different potential treatments for COVID-19. We've compiled these question-and-answer webinars, interviews, and discussions on COVID-19 below. During these sessions, many of your questions were asked and answered.

News Articles, Scientific Papers, Radio Programs, and More

The following links to news articles, scientific papers, radio programs, and other resources are also available on our Resources tab:

Videos: Q&As, Interviews, and Discussions with Dr. Ackerman

The following links will bring you to the videos about COVID-19 and other topics located on our Videos Archive tab.

Click on the links below to follow Dr. Ackerman and Mayo Clinic's Windland Smith Rice Genetic Heart Rhythm Clinic on Twitter for the most up-to-date information about COVID-19 and genetic heart rhythm disorders.

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