Remote Monitoring of the QT Interval During Polychemotherapy

Aim      To evaluate the incidence of prolonged corrected QT interval (QTc) by remote single-channel electrocardiogram (ECG) monitoring in primary oncological patients with elective polychemotherapy (PCT).

Material and methods  This study included 49 oncological patients with elective PCT. A single-channel portable CardioQVARK electrocardiograph was used to record single-channel, one-lead ECG between the first and second courses of PCT.

Results Analysis of QTc interval detected a prolonged QTc interval >500 msec in 8.2 % of cases, prolonged QTc >480 msec in 18.3 % f cases, and prolonged QTc interval >60 msec compared to baseline in 12.2 % of cases.

Conclusion      Remote recording of single-channel ECG using a portable electrocardiograph is an effective method for recording and detecting various forms of heart rhythm disorders.

1. Curigliano G, Cardinale D, Dent S, Criscitiello C, Aseyev O, Lenihan D et al. Cardiotoxicity of anticancer treatments: Epidemiology, detection, and management. CA: A Cancer Journal for Clinicians. 2016;66(4):309–25. DOI: 10.3322/caac.21341

2. Koutsoukis A, Ntalianis A, Repasos E, Kastritis E, Dimopoulos M-A, Paraskevaidis I. Cardio-oncology: A Focus on Cardiotoxicity. European Cardiology Review. 2018;13(1):64–9. DOI: 10.15420/ecr.2017:17:2

3. Tamargo J, Caballero R, Delpón E. Cancer Chemotherapy and Cardiac Arrhythmias: A Review. Drug Safety. 2015;38(2):129–52. DOI: 10.1007/s40264-014-0258-4

4. Porta‐Sánchez A, Gilbert C, Spears D, Amir E, Chan J, Nanthakumar K et al. Incidence, Diagnosis, and Management of QT Prolongation Induced by Cancer Therapies: A Systematic Review. Journal of the American Heart Association. 2017;6(12):e007724. DOI: 10.1161/JAHA.117.007724

5. Kim PY, Irizarry-Caro JA, Ramesh T, Iliescu C, Lopez-Mattei JC. How to Diagnose and Manage QT Prolongation in Cancer Patients. JACC: CardioOncology. 2021;3(1):145–9. DOI: 10.1016/j.jaccao.2021.01.002

6. Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). European Heart Journal. 2016;37(36):2768–801. DOI: 10.1093/eurheartj/ehw211

7. Vitsenya M.V., Ageev F.T., Gilyarov M.Yu., Ovchinnikov A.G., Orlova R.V., Poltavskaya M.G. Practical recommendations for the correction of cardiovascular toxicity of anticancer drug therapy. Malignant tumours. 2021;11(3s2-2):78–98. DOI: 10.18027/2224-5057-2021-11-3s2-41

8. Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace. 2015;17(11):1601–87. DOI: 10.1093/europace/euv319

9. Castelletti S, Winkel BG, Schwartz PJ. Remote Monitoring of the QT Interval and Emerging Indications for Arrhythmia Prevention. Cardiac Electrophysiology Clinics. 2021;13(3):523–30. DOI: 10.1016/j.ccep.2021.04.010

10. Sagirova Z, Kuznetsova N, Gogiberidze N, Gognieva D, Suvorov A, Chomakhidze P et al. Cuffless Blood Pressure Measurement Using a Smartphone-Case Based ECG Monitor with Photoplethysmography in Hypertensive Patients. Sensors. 2021;21(10):3525. DOI: 10.3390/s21103525

11. Sagirova Zh.N., Kuznetsova N.O., Larionov V.B., Chomakhidze P.Sh., Kopylov F.Yu., Syrkin A.L. Pulse wave parameters in assessment of left ventricular systolic function. Russian Journal of Cardiology and Cardiovascular Surgery. 2020;13(3):253–7. DOI: 10.17116/kardio202013031253

12. Garabelli P, Stavrakis S, Albert M, Koomson E, Parwani P, Chohan J et al. Comparison of QT Interval Readings in Normal Sinus Rhythm Between a Smartphone Heart Monitor and a 12-Lead ECG for Healthy Volunteers and Inpatients Receiving Sotalol or Dofetilide. Journal of Cardiovascular Electrophysiology. 2016;27(7):827–32. DOI: 10.1111/jce.12976

13. Bykova A.A., Chashkina M.I., Serova M.V., Simonov A.V., Kopylov F.Yu. The incidence of QT interval prolongation in patients receiving antituberculous therapy. Russian Journal of Cardiology and Cardiovascular Surgery. 2019;12(2):146–51. DOI: 10.17116/kardio201912021146

14. Kalatsei L.V., Snezhitskiy V.A. Methodological approaches to measuring and estimating the duration of QT interval of a standard electrocardiogram. Journal of the Grodno State Medical University. 2019;17(1):99–105. DOI: 10.25298/2221-8785-2019-17-1-99-105

15. Rautaharju PM, Surawicz B, Gettes LS. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram. Journal of the American College of Cardiology. 2009;53(11):982–91. DOI: 10.1016/j.jacc.2008.12.014

16. Vasyuk Yu.A., Shupenina E.Yu., Novosel E.O., Agapov I.S. Heart rhythm and conduction disorders as manifestations of cardiotoxicity of anticancer treatment: myth or reality? The Siberian Medical Journal. 2020;35(1):13–21. DOI: 10.29001/2073-8552-2020-35-1-13-21

17. Abraham TM, Pencina KM, Pencina MJ, Fox CS. Trends in Diabetes Incidence: The Framingham Heart Study. Diabetes Care. 2015;38(3):482–7. DOI: 10.2337/dc14-1432

18. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovascular Diabetology. 2018;17(1):83. DOI: 10.1186/s12933-018-0728-6

19. Singleton MJ, Soliman EZ, Bertoni AG, Whalen SP, Bhave PD, Yeboah J. Effect of Intensive Glycemic and Blood Pressure Control on QT Prolongation in Diabetes: The ACCORD Trial. Diabetes. 2020;69(10):2186–93. DOI: 10.2337/db20-0401

20. Esina M.V., Efremova O.N., Yamashkina E.I., Prekina V.I., Kozlov E.D. The study of the length of the QT interval in diabetes mellitus 1. Journal of scientific articles Health and education in the XXI century. 2016;18(9):27–30.