Comparison Between the 24-hour Holter Test and 72-hour Single-Lead Electrocardiogram Monitoring With an Adhesive Patch-Type Device for Atrial Fibrillation Detection: Prospective Cohort Study

Abstract

Background There is insufficient evidence for the use of single-lead electrocardiogram (ECG) monitoring with an adhesive patch-type device (APD) over an extended period compared to that of the 24-hour Holter test for atrial fibrillation (AF) detection. Objective In this paper, we aimed to compare AF detection by the 24-hour Holter test and 72-hour single-lead ECG monitoring using an APD among patients with AF. Methods This was a prospective, single-center cohort study. A total of 210 patients with AF with clinical indications for the Holter test at cardiology outpatient clinics were enrolled in the study. The study participants were equipped with both the Holter device and APD for the first 24 hours. Subsequently, only the APD continued ECG monitoring for an additional 48 hours. AF detection during the first 24 hours was compared between the two devices. The diagnostic benefits of extended monitoring using the APD were evaluated. Results A total of 200 patients (mean age 60 years; n=141, 70.5% male; and n=59, 29.5% female) completed 72-hour ECG monitoring with the APD. During the first 24 hours, both monitoring methods detected AF in the same 40/200 (20%) patients (including 20 patients each with paroxysmal and persistent AF). Compared to the 24-hour Holter test, the APD increased the AF detection rate by 1.5-fold (58/200; 29%) and 1.6-fold (64/200; 32%) with 48- and 72-hour monitoring, respectively. With the APD, the number of newly discovered patients with paroxysmal AF was 20/44 (45.5%), 18/44 (40.9%), and 6/44 (13.6%) at 24-, 48-, and 72-hour monitoring, respectively. Compared with 24-hour Holter monitoring, 72-hour monitoring with the APD increased the detection rate of paroxysmal AF by 2.2-fold (44/20). Conclusions Compared to the 24-hour Holter test, AF detection could be improved with 72-hour single-lead ECG monitoring with the APD.

Evaluation of the Diagnostic Performance and Efficacy of Wearable Electrocardiogram Monitoring for Arrhythmia Detection after Cardiac Surgery

“…In 2022, Kwon et al [ 11 ] compared the mobiCARE device to conventional Holter monitoring in patients in a cardiology outpatient department. They reviewed 200 patients who had previously been diagnosed with paroxysmal A-fib or were indicated for 24-hour Holter testing for A-fib monitoring at cardiology outpatient clinics.…”

The efficacy of detecting arrhythmia is higher with 7‐day continuous electrocardiographic patch monitoring than with 24‐h Holter monitoring

“…Among patients treated for atrial fibrillation, 72‐h single‐lead ECG monitoring was superior to 24‐h Holter monitoring; an additional 13.6% of patients with negative results in Holter monitoring were diagnosed with paroxysmal atrial fibrillation using 72‐h single‐lead ECG monitoring. 16 Undiagnosed paroxysmal atrial fibrillation can lead to recurrent stroke or embolic events. 17 , 18 In addition, a higher atrial burden is a significant risk factor for clinical atrial fibrillation and future stroke.…”

The diagnostic efficiency of artificial intelligence based 2 hours Holter monitoring in premature ventricular and supraventricular contractions detection

“…This allows for the detection of arrhythmias that occur intermittently. However, Holter monitoring has limitations in terms of patient compliance and discomfort owing to wearing the device for an extended period 12 . To overcome the limitations of ECG and Holter monitoring, event monitors, implantable loop recorders, and other wearable applications appeared and spread in last decade 13,14 .…”

“…However, Holter monitoring has limitations in terms of patient compliance and discomfort owing to wearing the device for an extended period. 12 To overcome the limitations of ECG and Holter monitoring, event monitors, implantable loop recorders, and other wearable applications appeared and spread in last decade. 13 , 14 In particular, the artificial intelligence (AI)‐based single‐lead Holter test exhibits outstanding comfortability and accessibility.…”