Association for Inherited Cardiac Conditions (AICC)
We aim to provide consistent, top quality education and training, advice on management and best practice, as well as acting as a forum for data collection, audit and collaborative research. Membership is open to clinicians, nurses, counsellors, scientists and professions allied to medicine, as well as to persons from organisations and charities involved in support of such families.
Management of inherited cardiac conditions is currently one of the most rapidly evolving areas in cardiology. The last decade has seen a major change in our recognition of these conditions from apparently rare isolated disorders, to a group which collectively are common and which may be associated with the tragedy of unnecessary sudden death.
The AICC wish to provide some guidance for its members in advising their patients with ICCs about COVID-19. This advice is consistent with that submitted to Specialist Commissioning and expected to be available on-line from NHS England and through 111.
All patients should follow relevant government advice on COVID-19 provided by the 111 website and call line.
Patients who are at increased risk of complications of infection who will require strict self-isolation to reduce the chance of contracting the virus:
- Dilated, arrhythmogenic and hypertrophic cardiomyopathy patients with LV impairment and/or symptomatic left heart failure.
- Arrhythmogenic cardiomyopathy patients with RV impairment and/or symptomatic right heart failure.
- Symptomatic hypertrophic cardiomyopathy with or without significant obstruction.
Patients who may require special instructions:
- All patients with Brugada syndrome and/or sodium channel disease should self-treat with paracetamol immediately if they develop signs of fever and self-isolate.
- If patients with Brugada syndrome and/or sodium channel disease without an ICD, especially those with a spontaneous type 1 pattern, develop a high fever (>38.5C) despite paracetamol, they should contact 111 by phone, stating their condition, and may need to attend A+E*. A+E will need to be advised either by 111 or by the patient that they will attend to allow assessment by staff with suitable protective equipment. Assessment should include an ECG** and monitoring for arrhythmia. If an ECG shows the type 1 Brugada ECG pattern, then the patient will need to be observed until fever and/or the ECG pattern resolves. If all ECGs show no sign of the type 1 ECG pattern, then they can go home to self-isolate. Patients with fever who have an ICD can isolate at home and follow guidance provided by 111.
* A+E attendance may be regulated according to the capacity of service and risk of COVID-19 infection.
** ideally three different ECGs with V1 and V2 in the 4th, 3rd and 2nd intercostal spaces should be taken.
Long QT syndrome patients infected with COVID-19 who receive antivirals and/or chloroquine/hydroxychloroquine will require ECG monitoring in case of exacerbation of QT prolongation and increased risk of arrhythmias during therapy.