Impact of Anti-Hepatitis C Therapy on Cardiac rhythm

Background The use of direct-acting antiviral (DAA) has raised some concerns about the possibilities of cardiac toxicity after US Food and Drug Administration (FDA) issued a safety announcement of serious slowing of the heart rate when Amiodarone was used with hepatitis C treatment . Aim The aim of the present study was to assess the impact of Anti-Hepatitis C Therapy on cardiac rhythm using 24 hours Holter monitoring. Methods The current study was conducted on fifty consecutive adult patients with chronic hepatitis C infection eligible for DAA therapy supplied in the outpatient clinic of Ain shams University Virology Center .Patients have received Sofosbuvir 400 mg and Daclatasvir 60 mg / day for 12 weeks. All patients underwent 24 hour Holter monitoring before and after the completion of therapy. Both recordings were compared as regards: heart rate, minimum and maximum heart rate, the presence and frequency of ectopic atrial or ventricular activity. The measurement of QRS intervals such PR, corrected QT intervals in msec. Results The pre and post analysis of the Holter recording was done with comparing different baseline and post therapy parameters, The pre and post therapy mean average heart rates were 79.44±10.14 bpm vs.79.96±8.77 bpm respectively (p = 0.534) which are non-significant changes. There is also non-significant change was observed in mean maximum and mean minimum heart rate 129.08±20.07 bpm 128.98±16.89 bpm (p = 0.964), 55.88±9.20 bpm 56.66±9.45 bpm (p = 0.457) respectively. And as regard corrected QT duration and PR interval duration, the mean pre-therapy PR interval was 154.00 ± 25.95 ms as compared to the mean post-medication PR interval duration 151.40 ± 23.82 ms (p = 0.124) and The mean premedication Corrected QT duration was 397.34 ± 29.38ms vs. post therapy 395.04 ± 30.23ms ( p = 0.403) Which showing a non-significant change of both intervals. And as regard the median pre-therapy and post medication PACs and PVCs numbers and the median pre-therapy and post medication attacks of tachycardia and bradycardia, they showed non-significant changes with P-value > 0.05 . Conclusions Novel DAAs are safe to use as regards its effect on cardiac rhythm