Diagnostic utility of a novel leadless arrhythmia monitoring device

Mintu P. Turakhia, Donald D. Hoang, Peter Zimetbaum, Jared Miller, Victor F. Froelicher, Uday N. Kumar, Xiangyan Xu, Felix Yang, Paul A. Heidenreich

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Although extending the duration of ambulatory electrocardiographic monitoring beyond 24 to 48 hours can improve the detection of arrhythmias, lead-based (Holter) monitors might be limited by patient compliance and other factors. We, therefore, evaluated compliance, analyzable signal time, interval to arrhythmia detection, and diagnostic yield of the Zio Patch, a novel leadless, electrocardiographic monitoring device in 26,751 consecutive patients. The mean wear time was 7.6 ± 3.6 days, and the median analyzable time was 99% of the total wear time. Among the patients with detected arrhythmias (60.3% of all patients), 29.9% had their first arrhythmia and 51.1% had their first symptom-triggered arrhythmia occur after the initial 48-hour period. Compared with the first 48 hours of monitoring, the overall diagnostic yield was greater when data from the entire Zio Patch wear duration were included for any arrhythmia (62.2% vs 43.9%, p <0.0001) and for any symptomatic arrhythmia (9.7% vs 4.4%, p <0.0001). For paroxysmal atrial fibrillation (AF), the mean interval to the first detection of AF was inversely proportional to the total AF burden, with an increasing proportion occurring after 48 hours (11.2%, 10.5%, 20.8%, and 38.0% for an AF burden of 51% to 75%, 26% to 50%, 1% to 25%, and <1%, respectively). In conclusion, extended monitoring with the Zio Patch for ≤14 days is feasible, with high patient compliance, a high analyzable signal time, and an incremental diagnostic yield beyond 48 hours for all arrhythmia types. These findings could have significant implications for device selection, monitoring duration, and care pathways for arrhythmia evaluation and AF surveillance.

Original languageEnglish (US)
Pages (from-to)520-524
Number of pages5
JournalAmerican Journal of Cardiology
Volume112
Issue number4
DOIs
StatePublished - Aug 15 2013
Externally publishedYes

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Cardiac Arrhythmias
Equipment and Supplies
Atrial Fibrillation
Patient Compliance
Ambulatory Electrocardiography
Compliance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Turakhia, M. P., Hoang, D. D., Zimetbaum, P., Miller, J., Froelicher, V. F., Kumar, U. N., ... Heidenreich, P. A. (2013). Diagnostic utility of a novel leadless arrhythmia monitoring device. American Journal of Cardiology, 112(4), 520-524. https://doi.org/10.1016/j.amjcard.2013.04.017

Diagnostic utility of a novel leadless arrhythmia monitoring device. / Turakhia, Mintu P.; Hoang, Donald D.; Zimetbaum, Peter; Miller, Jared; Froelicher, Victor F.; Kumar, Uday N.; Xu, Xiangyan; Yang, Felix; Heidenreich, Paul A.

In: American Journal of Cardiology, Vol. 112, No. 4, 15.08.2013, p. 520-524.

Research output: Contribution to journalArticle

Turakhia, MP, Hoang, DD, Zimetbaum, P, Miller, J, Froelicher, VF, Kumar, UN, Xu, X, Yang, F & Heidenreich, PA 2013, 'Diagnostic utility of a novel leadless arrhythmia monitoring device', American Journal of Cardiology, vol. 112, no. 4, pp. 520-524. https://doi.org/10.1016/j.amjcard.2013.04.017
Turakhia, Mintu P. ; Hoang, Donald D. ; Zimetbaum, Peter ; Miller, Jared ; Froelicher, Victor F. ; Kumar, Uday N. ; Xu, Xiangyan ; Yang, Felix ; Heidenreich, Paul A. / Diagnostic utility of a novel leadless arrhythmia monitoring device. In: American Journal of Cardiology. 2013 ; Vol. 112, No. 4. pp. 520-524.
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