If you have symptoms suggestive of the virus that you feel are not controlled at home, please be guided by the NHS 111 website at 111.nhs.uk/covid-19 or call 111 stating the condition you have.
If you do not have symptoms, please follow NHS guidelines for preventing spread as detailed here: www.gov.uk/government/publications/coronavirus-action-plan.
The following patients are at increased risk of complications of infection and will require strict self-isolation to reduce the chance of contracting the virus:
1. Dilated, arrhythmogenic and hypertrophic cardiomyopathy patients with LV impairment and/or symptomatic left heart failure.
2. Arrhythmogenic cardiomyopathy patients with RV impairment and/or symptomatic right heart failure.
3. Symptomatic hypertrophic cardiomyopathy with or without significant obstruction.
The following patients may require special instructions:
1. 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.
2. 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 (above 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 their 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.
3. 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.
