A meta-analysis of ECG abnormalities (arrhythmia) in cardiomyopathies

Background: There is no effective therapy for COVID-19. Hydroxychloroquine (HCQ) and chloroquine (CQ) have been used for its treatment but their safety and efficacy remain uncertain. Objective: We performed a systematic review to synthesize the available data on the efficacy and safety of CQ and HCQ for the treatment of COVID-19. Methods: Two reviewers searched for published and pre-published relevant articles between December 2019 to 8th June 2020. The data from the selected studies were abstracted and analyzed for efficacy and safety outcomes. Critical appraisal of the evidence was done by Cochrane risk of bias tool and Newcastle Ottawa scale. The quality of evidence was graded as per the GRADE approach. Results: We reviewed 12 observational and 3 randomized trials which included 10659 patients of whom 5713 received CQ/HCQ and 4966 received only standard of care. The efficacy of CQ/HCQ for COVID-19 was inconsistent across the studies. Meta-analysis of included studies revealed no significant reduction in mortality with HCQ use [RR 0.98 95% CI 0.66-1.46] , time to fever resolution [mean difference -0.54 days (-1.19-011)] or clinical deterioration/development of ARDS with HCQ [RR 0.90 95% CI 0.47-1.71]. There was a higher risk of ECG abnormalities/arrhythmia with HCQ/CQ [RR 1.46 95% CI 1.04 to 2.06]. The quality of evidence was graded as very low for these outcomes. Conclusions: The available evidence suggests that CQ or HCQ does not improve clinical outcomes in COVID-19. Well-designed randomized trials are required for assessing the efficacy and safety of HCQ and CQ for COVID-19.

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Abstract 18264: Abnormalities in the Electrocardiogram: a Meta-Analysis Comparing Chagas Disease to Other Cardiomyopathies

Circulation ◽

10.1161/circ.130.suppl_2.18264 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Rhanderson N Cardoso ◽

Gilson Fernandes ◽

Daniel Garcia ◽

Mohammad Ansari ◽

Raul D Mitrani

Keyword(s):

Chagas Disease ◽

Latin American ◽

Right Bundle Branch Block ◽

Meta Analysis ◽

Pacemaker Implantation ◽

Odds Ratios ◽

Positive Serology ◽

Bundle Branch Block ◽

Disease Etiology ◽

Ecg Abnormalities

Introduction: Chagas Disease (CD) has been associated with a variety of abnormalities in the electrocardiogram (ECG). For epidemiologic purposes and differential diagnosis, we sought to perform a systematic review and meta-analysis of the relative frequencies of various ECG findings in patients with CD compared to a non-CD group. Hypothesis: ECG abnormalities differ significantly based on etiology of cardiomyopathy. Methods: PubMed, EMBASE, Cochrane Central and Latin American databases were searched for studies that directly compared the prevalence of ECG abnormalities in CD patients to a non-CD group. Odds-ratios were computed using a random-effects model due to anticipated heterogeneity. We further performed a subanalysis on studies that included only patients with known cardiomyopathy. Results: A total of 17 studies and 10,550 patients were included, of whom 4,192 (39.7%) had a positive serology for CD. Ten studies included only patients with known cardiomyopathy in both the control and CD groups. Table 1 reports the odds-ratios for the relative frequencies of various ECG abnormalities between groups. Conclusions: Our analysis suggests that amongst patients with cardiomyopathies, Chagas Disease etiology is significantly associated with an increased prevalence of right bundle branch block, premature ventricular complexes and permanent pacemaker implantation, whereas left bundle branch block is more prevalent among other cardiomyopathies. The combination of right bundle branch block with left anterior fascicular block had the highest odds ratio for prevalence among Chagas Disease patients.

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Prevalence of Electrocardiographic Abnormalities Among People Living With HIV/AIDS in Sub-saharan Africa: Protocol for a Systematic Review and Meta-analysis

10.21203/rs.3.rs-743165/v1 ◽

2021 ◽

Author(s):

Andrew Weil M Semulimi ◽

Andrew Peter Kyazze ◽

John Mukisa ◽

Charles Batte ◽

Felix Bongomin

Keyword(s):

Systematic Review ◽

Cardiovascular Diseases ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Cochrane Library ◽

People Living With Hiv ◽

Sub Saharan ◽

Living With Hiv ◽

Ecg Abnormalities ◽

Hiv Aids

Abstract IntroductionElectrocardiographic (ECG) abnormalities are highly prevalent among people living with HIV/AIDS (PLWHA) contributing to the rising burden of cardiovascular diseases among this population. Sub-Saharan Africa (SSA) contributes more than two thirds to the global burden of HIV/AIDS. However, an accurate account of the prevalence of ECG abnormalities in SSA is unknown. This study aims to determine the prevalence of ECG abnormalities among PLWHA in Sub-Saharan Africa. Methods and analysisA systematic review and meta-analysis will be conducted. Databases including EMBASE, MEDLINE, African Journal Online and The Cochrane Library (Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Methodology Register) will be used to search for studies published between 1st January 2000 and 31st December 2020. Studies reporting any form of ECG abnormalities will be considered. Additionally, articles in both English and French will be reviewed. Articles will be screened and reviewed by two independent reviewers to determine their eligibility and any disagreement will be resolved through discussions with fourth and fifth reviewer. Eligibility of the studies will be assessed and judged based on the pre-set criteria. Retrieved studies will be assessed for validity using the Cochrane risk of bias tool and the modified Newcastle Ottawa Scale by two reviewers. Analysis of proportions will be done using STATA MP Version 16.0. A p<0.05 will be considered statistically significant.DiscussionIn the face of a growing burden of cardiovascular diseases among PLWHA, this study will provide an estimate of ECG abnormalities among PLWHA which will emphasize the importance of ECGs in screening for cardiovascular diseases in this population.Systematic review registration numberCRD42021243664.

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Systematic review and meta-analysis of cardiac involvement in mitochondrial myopathy

Neurology Genetics ◽

10.1212/nxg.0000000000000339 ◽

2019 ◽

Vol 5 (4) ◽

pp. e339 ◽

Cited By ~ 3

Author(s):

Asfia Quadir ◽

Carly Sabine Pontifex ◽

Helen Lee Robertson ◽

Christopher Labos ◽

Gerald Pfeffer

Keyword(s):

Systematic Review ◽

Mitochondrial Myopathy ◽

Meta Analysis ◽

Genetic Mutation ◽

Clinical Syndrome ◽

Genetic Mutations ◽

Cardiac Phenotype ◽

Clinical Syndromes ◽

Gene Defects ◽

Ecg Abnormalities

ObjectiveOur goal was to perform a systematic review of the literature to demonstrate the prevalence of cardiac abnormalities identified using cardiac investigations in patients with mitochondrial myopathy (MM).MethodsThis systematic review surveys the available evidence for cardiac investigations in MM from a total of 21 studies including 825 participants. Data were stratified by genetic mutation and clinical syndrome.ResultsWe identified echocardiogram and ECG as the principal screening modalities that identify cardiac structural (29%) and conduction abnormalities (39%) in various MM syndromes. ECG abnormalities were more prevalent in patients with m.3243A>G mutations than other gene defects, and patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) had a higher prevalence of ECG abnormalities than patients with other clinical syndromes. Echocardiogram abnormalities were significantly more prevalent in patients with m.3243A>G or m.8344A>G mutations compared with other genetic mutations. Similarly, MELAS and MERRF had a higher prevalence compared with other syndromes. We observed a descriptive finding of an increased prevalence of ECG abnormalities in pediatric patients compared with adults.ConclusionsThis analysis supports the presence of a more severe cardiac phenotype in MELAS and myoclonic epilepsy with ragged red fibres syndromes and with their commonly associated genetic mutations (m.3243A>G and m.8344A>G). This provides the first evidence basis on which to provide more intensive cardiac screening for patients with certain clinical syndromes and genetic mutations. However, the data are based on a small number of studies. We recommend further studies of natural history, therapeutic response, pediatric participants, and cardiac MRI as areas for future investigation.

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Comparing of the First Electrocardiographic Variables in Patients with Newly Diagnosed COVID-19 with Healthy Men Volunteer: A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v50i1.5071 ◽

2021 ◽

Author(s):

Mahdieh ARIAN ◽

Ali VALINEJADI ◽

Farveh VAKILIAN

Keyword(s):

Meta Analysis ◽

Substantial Effect ◽

Library Science ◽

Cochrane Library ◽

Qtc Interval ◽

Healthy Men ◽

Pr Interval ◽

Qrs Duration ◽

Time Of Admission ◽

Ecg Abnormalities

Background: We aimed to report the findings of the first Electrocardiography (ECG), before therapy initiation and receiving medication in COVID-19 patients, and to compare them with the ECG findings of healthy men. Methods: A comprehensive and regular search was performed through the keywords (“Electrocardiographic” OR “ECG” OR; ‘‘COVID-19’’ OR ‘‘Coronavirus Disease 2019’’) without time and language restrictions in the Web of Science, Scopus, ProQuest, Cochrane Library, Science Direct, Medline, PubMed and Google Scholar. After evaluating the quality and reviewing the biases, 27 studies were finally enrolled. Results: In 27 studies with a total number of 3994 COVID-19 patients, and mean age of 62.7 yr, 1993 subjects were male. The most common type of arrhythmia in them, especially in severe and critical cases, was 7% based on 10 studies (Atrial Fibrillation); while in 7 studies, QTc interval prolong (≥ 460 msec) was 15% and in 5 studies, QTc interval prolong (≥ 500 msec) was 18%. In COVID-19 patients at the time of admission and healthy men, HR (b per / min) was 85, 61.7 and PR interval (msec) was 285.4, 156 and QRS duration (msec) was 95, 94.3 and QT (msec) was 380. 384.1 and QTc (msec) (Bazett's formula) was 437, 387.1, respectively. In most cases, the variables were higher for COVID-19 patients. Conclusion: ECG abnormalities at the time of admission and prior to the initiation of medication that cause arrhythmic may have a clinically substantial effect on the course of the disease and confirm the effect of COVID-19 on increased cardiovascular risk in long-term.

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