Huntington’s disease (HD) is a heritable neurodegenerative disorder, with cardiac disease involved as one main cause of death.1,2 Patients on antipsychotics had a dose-related increased risk of sudden cardiac death on cohort study.3 These results suggest caution is indicated in using medications that may have additive cardiac risk.4 It has been advised that ECG monitoring should be done during admission and at least when multiple Psychotropic, and other predisposing factors for QT prolongation are present at admission.5Aim
To investigate the literature for studies concerned monitoring ECG in patients with HD on antipsychotic medication.Discussion
There are currently no specific standards for monitoring ECGs in patients on antipsychotics and/or patients at high risk of developing heart problems. The trust guidelines for physical assessment for patients states that an ECG should be undertaken on admission for patients who currently taking medication such as Antipsychotics. The RCPsych Consensus statement on high-dose antipsychotic medication and NICE guidance also similarly recommends ECG recording.Conclusion and recommendation
There is very little evidence in the literature investigate the monitoring of ECG in HD’s patients on antipsychotics. This require further exploration in the future. It’s important to monitor ECG at early stage in HD’s patients even before starting them on antipsychotics. I suggest to monitor ECGs at regular intervals in outpatients and inpatients settings. We should also seek advice from Cardiology team if there is any concern about the ECG’s findings. This will help in detecting early signs of cardiac problem and prevent further deterioration in the cardiac function. Cardiac distress can compromise the well-being and quality of life of HD’s patients.