Drug interactions between AF medications and proposed COVID-19
treatment
Many investigational drugs have been proposed for COVID-19. Safety
alerts due to drug side effects including long QT interval and
ventricular arrhythmias were raised for HCLQ and
azithromycin.35This red flag should be emphasized more
while these drugs were prescribed along with AF medications for rate and
rhythm control. AF medications include β-blockers, non-dihydropyridines
(DHP) calcium channel blockers (CCB), digoxin and antiarrhythmic
agents.36The use of these medications increases the
risk for serious side effects such as bradycardia, heart failure, long
QT interval, or torsades de pointes. Therefore, the guideline of medical
treatment for AF has been provided by the international
consensus.36Drug-drug interaction between AF and
COVID-19 medications might share common metabolism and side effects
(Table 1). In addition to the evaluation of baseline renal function,
liver function and ECG parameters when initiating medications, a
thoughtful consideration of drug interactions, adjustment, and
monitoring is critical for patient safety and therapeutic efficiency.