Background Electrocardiogram (ECG) interpretation is a core skill required of all doctors. Despite this, ECG interpretation remains suboptimal among medical students and doctors in clinical practice. This study assessed the impact of a short period of ECG teaching provided to medical students on completion of their academic curriculum. The primary outcome was the impact on students’ knowledge. The secondary outcome was the impact on confidence in ECG interpretation. Methods and Results Prospective cohort study of the impact of 2 hours of ECG teaching delivered by Cardiology trainees to final year medical students. Standardised 10 question examinations were given before and after the session. Questionnaires were given to assess confidence in ECG interpretation. Of 150 students who received teaching, 141 completed the pre-course examination and 139 completed the post-course examination (mean age 25.1 years; 55.5% female; 81.1% undergraduate). There was a statistically significant improvement in results after the course (p <0.001). The improvement was most significant in the assessment of heart rate and STEMI identification. Thirty-nine students completed feedback questionnaires. There was a statistically significant improvement in confidence in ECG interpretation (p <0.001). Conclusions This study showed an improvement in both ECG knowledge and confidence in ECG interpretation following 2 hours of teaching. The assessment of simple concepts such as heart rate improved more significantly than complex concepts such as conduction abnormalities. Our findings suggest a benefit from dedicated ECG revision programmes to enhance ECG knowledge and confidence in ECG interpretation.

Introduction: Hydroxychloroquine, with or without Azithromycin, was used as a treatment strategy for COVID-19 in March and April 2020. The use of Hydroxychloroquine (HCQ), with or without Azithromycin, may increase the risk of QT prolongation. This study was performed to assess the incidence and degree of QT prolongation in hospitalised COVID-19 patients treated with HCQ, and the association with morbidity and mortality. Methods and Results: Single centre retrospective observational study. Baseline corrected QT interval (QTc), peak QTc and change in QTc (∆QTc) were calculated for all patients. Known or suspected risk factors for QT prolongation were assessed. All patients were followed up for QT prolongation, length of stay, incidence of ICU admission and 30 day all-cause mortality. Sixty-two patients were included (mean age 67 years; 33.9% female). QT prolongation occurred in 62.9% of patients given HCQ, with ∆QTc ≥60msec or acquired QTc ≥500msec in 14.5% of patients. The mean ∆QTc was 28.4msec. QT prolongation was associated with increased mortality (OR 11.0; 95% CI 1.3 – 90.9; P=0.03). Conclusions: There was a high incidence of QT prolongation in patients who received HCQ as part of a COVID-19 treatment regimen. We observed an increased risk of death in patients with QT prolongation, as well as an increased incidence of ICU admission and longer length of stay in hospital. We recommend particular attention be paid to the risk of QT prolongation with novel treatment strategies for COVID-19. Further research is warranted on the effect of QT prolongation on clinical outcomes in COVID-19.