Smartwatch Electrocardiogram and Artificial Intelligence for Assessing Cardiac-Rhythm Safety of Drug Therapy in the COVID-19 Pandemic. The QT-logs study.
Identifieur interne : 000409 ( Main/Corpus ); précédent : 000408; suivant : 000410Smartwatch Electrocardiogram and Artificial Intelligence for Assessing Cardiac-Rhythm Safety of Drug Therapy in the COVID-19 Pandemic. The QT-logs study.
Auteurs : Baptiste Maille ; Marie Wilkin ; Matthieu Million ; Noémie Rességuier ; Frédéric Franceschi ; Linda Koutbi-Franceschi ; Jérôme Hourdain ; Elisa Martinez ; Maxime Zabern ; Christophe Gardella ; Hervé Tissot-Dupont ; Jagmeet P. Singh ; Jean-Claude Deharo ; Laurent FiorinaSource :
- International journal of cardiology [ 1874-1754 ] ; 2021.
English descriptors
- KwdEn :
- Adult (MeSH), Arrhythmias, Cardiac (chemically induced), Arrhythmias, Cardiac (diagnosis), Artificial Intelligence (MeSH), Azithromycin (adverse effects), Azithromycin (therapeutic use), COVID-19 (drug therapy), Electrocardiography (MeSH), Female (MeSH), Humans (MeSH), Hydroxychloroquine (adverse effects), Hydroxychloroquine (therapeutic use), Long QT Syndrome (epidemiology), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH).
- MESH :
- chemical , adverse effects : Azithromycin, Hydroxychloroquine.
- chemically induced : Arrhythmias, Cardiac.
- diagnosis : Arrhythmias, Cardiac.
- drug therapy : COVID-19.
- epidemiology : Long QT Syndrome.
- chemical , therapeutic use : Azithromycin, Hydroxychloroquine.
- Adult, Artificial Intelligence, Electrocardiography, Female, Humans, Male, Middle Aged, Pandemics.
Abstract
BACKGROUND
QTc interval monitoring, for the prevention of drug-induced arrhythmias is necessary, especially in the context of coronavirus disease 2019 (COVID-19). For the provision of widespread use, surrogates for 12‑lead ECG QTc assessment may be useful. This prospective observational study compared QTc duration assessed by artificial intelligence (AI-QTc) (Cardiologs®, Paris, France) on smartwatch single‑lead electrocardiograms (SW-ECGs) with those measured on 12‑lead ECGs, in patients with early stage COVID-19 treated with a hydroxychloroquine-azithromycin regimen.
METHODS
Consecutive patients with COVID-19 who needed hydroxychloroquine-azithromycin therapy, received a smartwatch (Withings Move ECG®, Withings, France). At baseline, day-6 and day-10, a 12‑lead ECG was recorded, and a SW-ECG was transmitted thereafter. Throughout the drug regimen, a SW-ECG was transmitted every morning at rest. Agreement between manual QTc measurement on a 12‑lead ECG and AI-QTc on the corresponding SW-ECG was assessed by the Bland-Altman method.
RESULTS
85 patients (30 men, mean age 38.3 ± 12.2 years) were included in the study. Fair agreement between manual and AI-QTc values was observed, particularly at day-10, where the delay between the 12‑lead ECG and the SW-ECG was the shortest (-2.6 ± 64.7 min): 407 ± 26 ms on the 12‑lead ECG vs 407 ± 22 ms on SW-ECG, bias -1 ms, limits of agreement -46 ms to +45 ms; the difference between the two measures was <50 ms in 98.2% of patients.
CONCLUSION
In real-world epidemic conditions, AI-QTc duration measured by SW-ECG is in fair agreement with manual measurements on 12‑lead ECGs. Following further validation, AI-assisted SW-ECGs may be suitable for QTc interval monitoring.
REGISTRATION
ClinicalTrial.govNCT04371744.
DOI: 10.1016/j.ijcard.2021.01.002
PubMed: 33524462
PubMed Central: PMC7845555
Links to Exploration step
pubmed:33524462Le document en format XML
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The QT-logs study.</title><author><name sortKey="Maille, Baptiste" sort="Maille, Baptiste" uniqKey="Maille B" first="Baptiste" last="Maille">Baptiste Maille</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Wilkin, Marie" sort="Wilkin, Marie" uniqKey="Wilkin M" first="Marie" last="Wilkin">Marie Wilkin</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Million, Matthieu" sort="Million, Matthieu" uniqKey="Million M" first="Matthieu" last="Million">Matthieu Million</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Resseguier, Noemie" sort="Resseguier, Noemie" uniqKey="Resseguier N" first="Noémie" last="Rességuier">Noémie Rességuier</name><affiliation><nlm:affiliation>Department of Epidemiology and Health Economics, APHM, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Franceschi, Frederic" sort="Franceschi, Frederic" uniqKey="Franceschi F" first="Frédéric" last="Franceschi">Frédéric Franceschi</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Koutbi Franceschi, Linda" sort="Koutbi Franceschi, Linda" uniqKey="Koutbi Franceschi L" first="Linda" last="Koutbi-Franceschi">Linda Koutbi-Franceschi</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Hourdain, Jerome" sort="Hourdain, Jerome" uniqKey="Hourdain J" first="Jérôme" last="Hourdain">Jérôme Hourdain</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Martinez, Elisa" sort="Martinez, Elisa" uniqKey="Martinez E" first="Elisa" last="Martinez">Elisa Martinez</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Zabern, Maxime" sort="Zabern, Maxime" uniqKey="Zabern M" first="Maxime" last="Zabern">Maxime Zabern</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Gardella, Christophe" sort="Gardella, Christophe" uniqKey="Gardella C" first="Christophe" last="Gardella">Christophe Gardella</name><affiliation><nlm:affiliation>Cardiologs Technologies, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Tissot Dupont, Herve" sort="Tissot Dupont, Herve" uniqKey="Tissot Dupont H" first="Hervé" last="Tissot-Dupont">Hervé Tissot-Dupont</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Singh, Jagmeet P" sort="Singh, Jagmeet P" uniqKey="Singh J" first="Jagmeet P" last="Singh">Jagmeet P. Singh</name><affiliation><nlm:affiliation>Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Deharo, Jean Claude" sort="Deharo, Jean Claude" uniqKey="Deharo J" first="Jean-Claude" last="Deharo">Jean-Claude Deharo</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France. Electronic address: jean-claude.deharo@ap-hm.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Fiorina, Laurent" sort="Fiorina, Laurent" uniqKey="Fiorina L" first="Laurent" last="Fiorina">Laurent Fiorina</name><affiliation><nlm:affiliation>Institut Cardiovasculaire Paris-Sud, Hôpital Privé Jacques Cartier, Ramsay, Massy, France.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33524462</idno><idno type="pmid">33524462</idno><idno type="doi">10.1016/j.ijcard.2021.01.002</idno><idno type="pmc">PMC7845555</idno><idno type="wicri:Area/Main/Corpus">000409</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000409</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Smartwatch Electrocardiogram and Artificial Intelligence for Assessing Cardiac-Rhythm Safety of Drug Therapy in the COVID-19 Pandemic. The QT-logs study.</title><author><name sortKey="Maille, Baptiste" sort="Maille, Baptiste" uniqKey="Maille B" first="Baptiste" last="Maille">Baptiste Maille</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Wilkin, Marie" sort="Wilkin, Marie" uniqKey="Wilkin M" first="Marie" last="Wilkin">Marie Wilkin</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Million, Matthieu" sort="Million, Matthieu" uniqKey="Million M" first="Matthieu" last="Million">Matthieu Million</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Resseguier, Noemie" sort="Resseguier, Noemie" uniqKey="Resseguier N" first="Noémie" last="Rességuier">Noémie Rességuier</name><affiliation><nlm:affiliation>Department of Epidemiology and Health Economics, APHM, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Franceschi, Frederic" sort="Franceschi, Frederic" uniqKey="Franceschi F" first="Frédéric" last="Franceschi">Frédéric Franceschi</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Koutbi Franceschi, Linda" sort="Koutbi Franceschi, Linda" uniqKey="Koutbi Franceschi L" first="Linda" last="Koutbi-Franceschi">Linda Koutbi-Franceschi</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Hourdain, Jerome" sort="Hourdain, Jerome" uniqKey="Hourdain J" first="Jérôme" last="Hourdain">Jérôme Hourdain</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Martinez, Elisa" sort="Martinez, Elisa" uniqKey="Martinez E" first="Elisa" last="Martinez">Elisa Martinez</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Zabern, Maxime" sort="Zabern, Maxime" uniqKey="Zabern M" first="Maxime" last="Zabern">Maxime Zabern</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Gardella, Christophe" sort="Gardella, Christophe" uniqKey="Gardella C" first="Christophe" last="Gardella">Christophe Gardella</name><affiliation><nlm:affiliation>Cardiologs Technologies, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Tissot Dupont, Herve" sort="Tissot Dupont, Herve" uniqKey="Tissot Dupont H" first="Hervé" last="Tissot-Dupont">Hervé Tissot-Dupont</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Singh, Jagmeet P" sort="Singh, Jagmeet P" uniqKey="Singh J" first="Jagmeet P" last="Singh">Jagmeet P. Singh</name><affiliation><nlm:affiliation>Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Deharo, Jean Claude" sort="Deharo, Jean Claude" uniqKey="Deharo J" first="Jean-Claude" last="Deharo">Jean-Claude Deharo</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France. Electronic address: jean-claude.deharo@ap-hm.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Fiorina, Laurent" sort="Fiorina, Laurent" uniqKey="Fiorina L" first="Laurent" last="Fiorina">Laurent Fiorina</name><affiliation><nlm:affiliation>Institut Cardiovasculaire Paris-Sud, Hôpital Privé Jacques Cartier, Ramsay, Massy, France.</nlm:affiliation></affiliation></author></analytic><series><title level="j">International journal of cardiology</title><idno type="eISSN">1874-1754</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Arrhythmias, Cardiac (chemically induced)</term><term>Arrhythmias, Cardiac (diagnosis)</term><term>Artificial Intelligence (MeSH)</term><term>Azithromycin (adverse effects)</term><term>Azithromycin (therapeutic use)</term><term>COVID-19 (drug therapy)</term><term>Electrocardiography (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (adverse effects)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Long QT Syndrome (epidemiology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Azithromycin</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Arrhythmias, Cardiac</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Arrhythmias, Cardiac</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Long QT Syndrome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Azithromycin</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Artificial Intelligence</term><term>Electrocardiography</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>QTc interval monitoring, for the prevention of drug-induced arrhythmias is necessary, especially in the context of coronavirus disease 2019 (COVID-19). For the provision of widespread use, surrogates for 12‑lead ECG QTc assessment may be useful. This prospective observational study compared QTc duration assessed by artificial intelligence (AI-QTc) (Cardiologs®, Paris, France) on smartwatch single‑lead electrocardiograms (SW-ECGs) with those measured on 12‑lead ECGs, in patients with early stage COVID-19 treated with a hydroxychloroquine-azithromycin regimen.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Consecutive patients with COVID-19 who needed hydroxychloroquine-azithromycin therapy, received a smartwatch (Withings Move ECG®, Withings, France). At baseline, day-6 and day-10, a 12‑lead ECG was recorded, and a SW-ECG was transmitted thereafter. Throughout the drug regimen, a SW-ECG was transmitted every morning at rest. Agreement between manual QTc measurement on a 12‑lead ECG and AI-QTc on the corresponding SW-ECG was assessed by the Bland-Altman method.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>85 patients (30 men, mean age 38.3 ± 12.2 years) were included in the study. Fair agreement between manual and AI-QTc values was observed, particularly at day-10, where the delay between the 12‑lead ECG and the SW-ECG was the shortest (-2.6 ± 64.7 min): 407 ± 26 ms on the 12‑lead ECG vs 407 ± 22 ms on SW-ECG, bias -1 ms, limits of agreement -46 ms to +45 ms; the difference between the two measures was <50 ms in 98.2% of patients.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>In real-world epidemic conditions, AI-QTc duration measured by SW-ECG is in fair agreement with manual measurements on 12‑lead ECGs. Following further validation, AI-assisted SW-ECGs may be suitable for QTc interval monitoring.</p></div><div type="abstract" xml:lang="en"><p><b>REGISTRATION</b></p><p>ClinicalTrial.govNCT04371744.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">33524462</PMID><DateCompleted><Year>2021</Year><Month>04</Month><Day>23</Day></DateCompleted><DateRevised><Year>2021</Year><Month>04</Month><Day>23</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1874-1754</ISSN><JournalIssue CitedMedium="Internet"><Volume>331</Volume><PubDate><Year>2021</Year><Month>05</Month><Day>15</Day></PubDate></JournalIssue><Title>International journal of cardiology</Title><ISOAbbreviation>Int J Cardiol</ISOAbbreviation></Journal><ArticleTitle>Smartwatch Electrocardiogram and Artificial Intelligence for Assessing Cardiac-Rhythm Safety of Drug Therapy in the COVID-19 Pandemic. The QT-logs study.</ArticleTitle><Pagination><MedlinePgn>333-339</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0167-5273(21)00081-4</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijcard.2021.01.002</ELocationID><Abstract><AbstractText Label="BACKGROUND">QTc interval monitoring, for the prevention of drug-induced arrhythmias is necessary, especially in the context of coronavirus disease 2019 (COVID-19). For the provision of widespread use, surrogates for 12‑lead ECG QTc assessment may be useful. This prospective observational study compared QTc duration assessed by artificial intelligence (AI-QTc) (Cardiologs®, Paris, France) on smartwatch single‑lead electrocardiograms (SW-ECGs) with those measured on 12‑lead ECGs, in patients with early stage COVID-19 treated with a hydroxychloroquine-azithromycin regimen.</AbstractText><AbstractText Label="METHODS">Consecutive patients with COVID-19 who needed hydroxychloroquine-azithromycin therapy, received a smartwatch (Withings Move ECG®, Withings, France). At baseline, day-6 and day-10, a 12‑lead ECG was recorded, and a SW-ECG was transmitted thereafter. Throughout the drug regimen, a SW-ECG was transmitted every morning at rest. Agreement between manual QTc measurement on a 12‑lead ECG and AI-QTc on the corresponding SW-ECG was assessed by the Bland-Altman method.</AbstractText><AbstractText Label="RESULTS">85 patients (30 men, mean age 38.3 ± 12.2 years) were included in the study. Fair agreement between manual and AI-QTc values was observed, particularly at day-10, where the delay between the 12‑lead ECG and the SW-ECG was the shortest (-2.6 ± 64.7 min): 407 ± 26 ms on the 12‑lead ECG vs 407 ± 22 ms on SW-ECG, bias -1 ms, limits of agreement -46 ms to +45 ms; the difference between the two measures was <50 ms in 98.2% of patients.</AbstractText><AbstractText Label="CONCLUSION">In real-world epidemic conditions, AI-QTc duration measured by SW-ECG is in fair agreement with manual measurements on 12‑lead ECGs. Following further validation, AI-assisted SW-ECGs may be suitable for QTc interval monitoring.</AbstractText><AbstractText Label="REGISTRATION">ClinicalTrial.govNCT04371744.</AbstractText><CopyrightInformation>Copyright © 2021 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Maille</LastName><ForeName>Baptiste</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wilkin</LastName><ForeName>Marie</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Million</LastName><ForeName>Matthieu</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rességuier</LastName><ForeName>Noémie</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Epidemiology and Health Economics, APHM, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Franceschi</LastName><ForeName>Frédéric</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koutbi-Franceschi</LastName><ForeName>Linda</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hourdain</LastName><ForeName>Jérôme</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Martinez</LastName><ForeName>Elisa</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zabern</LastName><ForeName>Maxime</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gardella</LastName><ForeName>Christophe</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Cardiologs Technologies, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tissot-Dupont</LastName><ForeName>Hervé</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Singh</LastName><ForeName>Jagmeet P</ForeName><Initials>JP</Initials><AffiliationInfo><Affiliation>Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Deharo</LastName><ForeName>Jean-Claude</ForeName><Initials>JC</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France; Aix Marseille University, C2VN, Marseille, France. Electronic address: jean-claude.deharo@ap-hm.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fiorina</LastName><ForeName>Laurent</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Institut Cardiovasculaire Paris-Sud, Hôpital Privé Jacques Cartier, Ramsay, Massy, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><DataBankList CompleteYN="Y"><DataBank><DataBankName>ClinicalTrials.gov</DataBankName><AccessionNumberList><AccessionNumber>NCT04371744</AccessionNumber></AccessionNumberList></DataBank></DataBankList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>01</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Int J Cardiol</MedlineTA><NlmUniqueID>8200291</NlmUniqueID><ISSNLinking>0167-5273</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>83905-01-5</RegistryNumber><NameOfSubstance UI="D017963">Azithromycin</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001145" MajorTopicYN="N">Arrhythmias, Cardiac</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="N">chemically induced</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001185" MajorTopicYN="Y">Artificial Intelligence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017963" MajorTopicYN="N">Azithromycin</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004562" MajorTopicYN="Y">Electrocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008133" MajorTopicYN="Y">Long QT Syndrome</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Artificial intelligence</Keyword><Keyword MajorTopicYN="Y">COVID-19</Keyword><Keyword MajorTopicYN="Y">Hydroxychloroquine-azythromycine</Keyword><Keyword MajorTopicYN="Y">QTc interval</Keyword><Keyword MajorTopicYN="Y">Smartwatch</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>10</Month><Day>07</Day></PubMedPubDate><PubMedPubDate 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