COVID-19 Care

1. What is the QTc?

   The QTc is the corrected QT interval. It is usually calculated using Leads II, V5, or V6. The QT interval varies with heart rate and must be corrected to the QTc to accurately measure the QT interval and assess the risk. The QT interval is prolonged at slower heart rates and shortened at faster heart rates.

2. How does one calculate the QTc using Lead II from a 6 lead mobile ECG?

   Click here for the Inpatient Informational Handout to capture and submit for QTc calculation of a KardiaMobile 6L recording. To manually calculate the QTc we recommend either using an EKG ruler and following the instructions provided with the ruler, or you can use ECG calipers to manually measure the QT and RR intervals, which will be needed to calculate the QTc.

3. Will the QTc analysis include a wide QRS adjustment?

   No, the QTc analysis will not include a wide QRS adjustment. For patients with a wide QRS from either ventricular pacing or left/right bundle branch block, a wide-QRS QTc adjustment should be made. Clinicians who are managing COVID-19 patients and are unsure whether this adjustment should be made if their QTc is >= 500ms should consult with cardiology before making a medication decision.

4. How were the threshold QTc values in the Mayo protocol determined?

   Mayo protocol QTc threshold values were based on the average values observed in their patients with long QT syndrome (LQTS).

   	Average, QTc values (ms)	99th percentile value Potential Increased Risk (ms)
   Healthy, postpubertal MALE	410	470
   Healthy, postpubertal FEMALE	420	480
   Prepubertal MALE/FEMALE		460

   Patients with a resting QTc³ 500ms have a significantly greater risk for drug-induced Torsades de Pointes (DI-TdP) and drug-induced sudden cardiac death (DI-SCD). Therefore, these values were used to define risk in the Mayo protocol.

1. What is KardiaMobile 6L?

   AliveCor’s KardiaMobile 6L is a six-lead personal ECG. KardiaMobile 6L has two electrodes on the top for your fingers, and one on the bottom to contact the skin of your left leg or hip, allowing you to take a medical-grade ECG without messy gels and wires. KardiaMobile 6L delivers ECG Leads I, II, III, aVL, aVR, and aVF. It is the only personal ECG that includes Lead II, which is the most critical for assessing patients for QT prolongation.

2. Will I be able to see the QTc analysis results immediately?

   No. KardiaMobile 6L is not performing the QTc analysis. ECGs recorded using KardiaMobile 6L will be sent to an independent testing facility that will conduct the QTc analysis. Results will be available in KardiaPro in approximately one hour.

3. Where can I purchase this product?

   Please fill out this form to place an order.

4. How should KardiaMobile 6L be cleaned?

   KardiaMobile 6L is recommended for single patient use. Approved cleaners include soap water solution or bleach solution as recommended by the CDC. To clean: spray the cleaner on a soft cloth, and thoroughly wipe the device. Ensure the device is sufficiently dried. Precaution: Do not use disinfecting wipes or alcohol-based products, as these products could adversely affect the product performance.

5. What technology will I need to record and interpret ECG recordings?

   You will need a KardiaMobile 6L device, access to the KardiaStation app, as well as access to the KardiaPro platform. Gain access to this technology by filling out this form.

6. If a COVID-19 patient already has KardiaMobile 6L can it be used in the hospital?

   Yes, the KardiaStation app that is used in the inpatient setting will pair with any KardiaMobile device. You must ensure that the patient’s device is a KardiaMobile 6L, as a six-lead ECG will be needed for QTc assessment.

7. I had a follow-up visit with a COVID-19 patient that was discharged from the hospital with a KardiaMobile 6L. Can I add that patient to my KardiaPro account?

   Yes, if your institution uses the same KardiaPro account for inpatient and outpatient settings, then it is possible for your outpatient practice to connect with the patient’s KardiaMobile 6L as long as the patient has a connection plan for the outpatient setting.

8. I already manage patients in my cardiology practice with KardiaPro, will I be able to see patients in the hospital using KardiaMobile through my KardiaPro?

   Yes, you will be able to see patients in both outpatient and inpatient settings provided your health care system uses the same KardiaPro organizational account.

9. Is it possible to have our own cardiologists conduct the QTc analysis instead?

   Yes, ECG recordings in KardiaPro can be reviewed and interpreted, including QTc analysis, without sending for analysis to the independent testing facility. Sending an ECG for QTc analysis to the independent testing facility is an option that can be selected in KardiaStation when an ECG is recording or via KardiaPro at any time after the ECG is recorded. The QTc analysis option was added for hospitals that do not have sufficient cardiology resources to support the medication management of all of their COVID-19 patients.

10. Can I use KardiaMobile (single-lead device) or an Apple Watch instead of KardiaMobile 6L?

    No. KardiaMobile and Apple Watch record Lead I ECGs only. Lead II is the best source for monitoring QTc and has been used to set the standard for potentially life threatening QT prolongation. KardiaMobile 6L records Leads I, II, III, aVR, aVL, and aVF.

For customer support or questions, please contact support@alivecor.com.