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Use of a Noninvasive Continuous Monitoring Device in the Management of Atrial Fibrillation: A Pilot Study
Author(s) -
ROSENBERG MICHAEL A.,
SAMUEL MICHELLE,
THOSANI AMIT,
ZIMETBAUM PETER J.
Publication year - 2013
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12053
Subject(s) - medicine , atrial fibrillation , ambulatory , holter monitor , cardiology , continuous monitoring , electrocardiography , anesthesia , operations management , economics
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 .