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

Abstract

Background: Detecting high-risk arrhythmia is important in diagnosing patients with palpitations. We compared the diagnostic accuracies of 7-day patch-type electrocardiographic (ECG) monitoring and 24-h Holter monitoring for detecting significant arrhythmias in patients with palpitations. Methods:This was a single-center prospective trial with 58 participants who presented with palpitations, chest pain or syncope. Outcomes were defined as the detection of any one of six arrhythmias, including supraventricular tachycardia (SVT), atrial fibrillation or atrial flutter lasting more than 30 s, pauses of more than 3 s, high-degree atrioventricular block, ventricular tachycardia (VT) >3 beats, or polymorphic VT/ventricular fibrillation. The McNemar test for paired proportions was used to compare arrhythmia detection rates. Results:The overall arrhythmia detection rate was higher with 7-day ECG patch monitoring than with 24-h Holter monitoring (34.5% vs. 19.0%, p = .008). Compared with the use of 24-h Holter monitors, the use of 7-day ECG patch monitors was associated with higher detection of SVT (29.3% vs. 13.8%, p = .042). No serious adverse skin reactions were reported among the ECG patch-monitored participants. Conclusions:The results suggest that a 7-day patch-type continuous ECG monitor is more effective for the detection of supraventricular tachycardia than is a 24-h Holter monitor. However, the clinical significance of device detected arrhythmia should be consolidated.

Telehealth Follow-up Using a Real-Time Electrocardiogram Device Improves Electrocardiogram Monitoring Duration and Patient Satisfaction After Catheter Ablation

“…Previous studies have shown that the duration of ECG monitoring and the use of monitoring devices greatly improved the detection of arrhythmia recurrence after catheter ablation. 1 , 4 – 6 Generally, a 24-h Holter ECG examination is most often used to identify arrhythmia recurrence after catheter ablation. However, this procedure requires that patients visit the hospital several times to undergo the examination.…”

“…The detection rate of arrhythmia was significantly lower with the 24-h Holter ECG than with 7-day ECG monitoring in patients after catheter ablation. 6 …”

“…Consequently, ECG monitoring and its duration are crucial factors for detecting arrhythmia after catheter ablation. 1 , 4 – 6 We previously reported the practical utility of using the postal service for the delivery of patch-type, self-fitted, wearable ECG monitoring devices (Duranta; ZAIKEN, Tokyo, Japan) for the long-term ECG recording in outpatient care. 7 The postal service safely delivered the ECG devices between the patients’ homes and the hospital, allowing the patients to perform long-term ECG recording themselves without needing to visit the hospital.…”

Comparison of Novel Telemonitoring System Using the Single-lead Electrocardiogram Patch With Conventional Telemetry System

“… 6) Nonetheless, they offer considerable advantages over traditional methods such as Holter recording, particularly in diagnosing arrhythmias, owing to their long-term duration of monitoring. 7) 8) 9) 10) …”

How to demonstrate clinical implication of 7‐day continuous electrocardiographic patch monitoring

“…Kim and colleagues demonstrated that a 7‐day patch‐type continuous electrocardiogram (ECG) monitor (MEMO patch®) had acceptable feasibility and efficacy in detecting arrhythmias when compared with conventional 24‐h Holter ECG monitoring. 1 Several concerns have been raised.…”