ABC | Volume 114, Nº6, June 2020

Viewpoint Wu et al. Preventing Torsades de Pointes during Hydroxychloroquine/Azithromycin Treatment Arq Bras Cardiol. 2020; 114(6):1061-1066 Age ≥ 65 years Sex Female Comorbidities (Tab.1) > 1 No. of drugs (Tab. 2) > 3 2 FH of Sudden Death Yes (< 45 years) FH of LQTS Yes Laboratory tests Creatinine Potassium < 3,5 3,5 -4,0 > 4,0 Magnesium <1,8 1,8-2,0 > 2,0 Ionized calcium <1,15 Baseline ECG ≥ 500 ms 470 – 500 ms 450 – 470 ms ≤ 450 ms Figure 5 – Pre-treatment Checklist: FH = family history; LQTS=long QT syndrome Red: special attention to conditions of risk; orange: moderate risk; green: low risk or desirable target Figure 6 – Control Checklist. * Clinical and metabolic conditions during clinical evolution: myocardial injuries, among others. Comorbidities (Table 1)* > 1 No. of drugs (Table 2) > 3 2 Laboratory tests Creatinine Potassium < 3.5 3.5 -4.0 > 4.0 Magnesium <1.8 1.8-2.0 > 2.0 Ionized calcium <1.15 Control ECG ≥ 520 ms QT variation ≥ 60 ms or 10% of baseline Table 1 – Risk factors for prolonged QT and TdP. (18) • Age > 65 years • Women • Electrolyte disorders (hypocalcemia, hypokalemia, hypomagnesemia) • Concomitant use of other medications that prolong QT (crediblemeds.org) • Acute coronary failure • Chronic heart failure or LVEF < 40% • Bradycardia, branch block • Hypertrophic cardiomyopathy • Congenital long QT syndrome or other genetic susceptibility • Diabetes mellitus • Chronic renal failure on dialysis • Anorexia or starvation • Hypoglycemia • Pheochromocytoma • Recent post-cardiorespiratory arrest • Post-subarachnoid hemorrhage, stroke, or traumatic brain injury (week 1). 1064