Use of a Noninvasive Continuous Monitoring Device in the Management of Atrial Fibrillation: A Pilot Study

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Abstract

Background:

Outpatient ambulatory cardiac rhythm monitoring is a routine part of the management of patients with paroxysmal atrial fibrillation (AF). Current systems are limited by patient convenience and practicality.

Methods:

We compared the Zio®Patch, a single-use, noninvasive waterproof long-term continuous monitoring patch, with a 24-hour Holter monitor in 74 consecutive patients with paroxysmal AF referred for Holter monitoring for detection of arrhythmias.

Results:

The Zio®Patch was well tolerated, with a mean monitoring period of 10.8 ± 2.8 days (range 4–14 days). Over a 24-hour period, there was excellent agreement between the Zio®Patch and Holter for identifying AF events and estimating AF burden. Although there was no difference in AF burden estimated by the Zio®Patch and the Holter monitor, AF events were identified in 18 additional individuals, and the documented pattern of AF (persistent or paroxysmal) changed in 21 patients after Zio®Patch monitoring. Other clinically relevant cardiac events recorded on the Zio®Patch after the first 24 hours of monitoring, including symptomatic ventricular pauses, prompted referrals for pacemaker placement or changes in medications. As a result of the findings from the Zio®Patch, 28.4% of patients had a change in their clinical management.

Conclusions:

The Zio®Patch was well tolerated, and allowed significantly longer continuous monitoring than a Holter, resulting in an improvement in clinical accuracy, the detection of potentially malignant arrhythmias, and a meaningful change in clinical management. Further studies are necessary to examine the long-term impact of the use of the Zio®Patch in AF management.

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