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

• Published in: Pacing and clinical electrophysiology 2013-03, Vol.36 (3), p.328-333
• Main Authors: ROSENBERG, MICHAEL A., SAMUEL, MICHELLE, THOSANI, AMIT, ZIMETBAUM, PETER J.
• Format: Article
• Language: English
• Subjects: Aged; arrhythmias; Arrhythmias, Cardiac - diagnosis; atrial fibrillation; Atrial Fibrillation - diagnosis; cardiac rhythm monitoring; Devices; Electrocardiography, Ambulatory - instrumentation; Female; Humans; Male; Middle Aged; Pilot Projects
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.12053

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.