Elsevier

The American Journal of Medicine

Volume 127, Issue 1, January 2014, Pages 95.e11-95.e17
The American Journal of Medicine

AJM online
Clinical research study
Comparison of 24-hour Holter Monitoring with 14-day Novel Adhesive Patch Electrocardiographic Monitoring

https://doi.org/10.1016/j.amjmed.2013.10.003Get rights and content
Under a Creative Commons license
open access

Abstract

Background

Cardiac arrhythmias are remarkably common and routinely go undiagnosed because they are often transient and asymptomatic. Effective diagnosis and treatment can substantially reduce the morbidity and mortality associated with cardiac arrhythmias. The Zio Patch (iRhythm Technologies, Inc, San Francisco, Calif) is a novel, single-lead electrocardiographic (ECG), lightweight, Food and Drug Administration–cleared, continuously recording ambulatory adhesive patch monitor suitable for detecting cardiac arrhythmias in patients referred for ambulatory ECG monitoring.

Methods

A total of 146 patients referred for evaluation of cardiac arrhythmia underwent simultaneous ambulatory ECG recording with a conventional 24-hour Holter monitor and a 14-day adhesive patch monitor. The primary outcome of the study was to compare the detection arrhythmia events over total wear time for both devices. Arrhythmia events were defined as detection of any 1 of 6 arrhythmias, including supraventricular tachycardia, atrial fibrillation/flutter, pause greater than 3 seconds, atrioventricular block, ventricular tachycardia, or polymorphic ventricular tachycardia/ventricular fibrillation. McNemar's tests were used to compare the matched pairs of data from the Holter and the adhesive patch monitor.

Results

Over the total wear time of both devices, the adhesive patch monitor detected 96 arrhythmia events compared with 61 arrhythmia events by the Holter monitor (P < .001).

Conclusions

Over the total wear time of both devices, the adhesive patch monitor detected more events than the Holter monitor. Prolonged duration monitoring for detection of arrhythmia events using single-lead, less-obtrusive, adhesive-patch monitoring platforms could replace conventional Holter monitoring in patients referred for ambulatory ECG monitoring.

Keywords

Atrial fibrillation
Cardiac arrhythmias
Electrocardiographic
Holter monitor
iRhythm
Zio Patch

Cited by (0)

Funding: This study was supported in part by Clinical and Translational Science Award funding to the Scripps Translational Science Institute (National Institutes of Health/National Center for Advancing Translational Sciences UL1 TR000109) and iRhythm Technologies Inc, San Francisco, Calif. ClinicalTrials.gov identifier: NCT01559246.

Conflict of Interest: None.

Authorship: All authors had access to the data and played a role in writing this manuscript.