Comparison of Arrhythmia Detection by 24-Hour Holter and 14-Day Continuous Electrocardiography Patch Monitoring

• Published in: Acta Cardiologica Sinica Vol. 36; no. 3; pp. 251 - 259
• Main Authors: Chua, Su-Kiat, Chen, Lung-Ching, Lien, Li-Ming, Lo, Huey-Ming, Liao, Zhen-Yu, Chao, Shu-Ping, Chuang, Cheng-Yen, Chiu, Chiung-Zuan
• Format: Journal Article
• Language: English
• Published: 台灣 中華民國心臟學會 01.05.2020; Taiwan Society of Cardiology
• Subjects: Arrhythmia; Atrial fibrillation; ECG monitoring patch; EP & Arrhythmia; Holter monitor; MEDLINE; Original; SCIE; Scopus; ECG monitoring patch; Holter monitor; Arrhythmia; Atrial fibrillation
• DOI: 10.6515/ACS.202005_36(3).20190903A
• ISSN: 1011-6842

Background: Although 24-hour Holter monitoring is routinely used for patients with suspected paroxysmal arrhythmia, its sensitivity in detecting such arrhythmias is insufficient. Methods: We compared a 14-day electrocardiography (ECG) monitor patch-a single-use, noninvasive, waterproof, continuous monitoring patch-with a 24-hour Holter monitor in 32 consecutive patients with suspected arrhythmia. Results: The 14-day ECG patch was well tolerated, and its rates of detection of relevant arrhythmias on days 1, 3, 7, and 14 were 13%, 28%, 47%, and 66%, respectively. The detection rate of paroxysmal arrhythmias was significantly higher for the 14-day ECG patch than for the 24-hour Holter monitor (66% vs. 9%, p ＜ 0.001). Among the 32 patients, 202 atrial fibrillation or atrial flutter episodes were detected in 6 patients (22%) with the 14-day ECG patch; however, only 1 atrial fibrillation episode was detected in a patient (3%, p ＜ 0.05) with the 24-hour Holter monitor. Other clinically relevant arrhythmias recorded on the 14-day ECG patch included 21 (65.5%) episodes of supraventricular tachycardia, 2 (6.3%) long pause, and 2 (6.3%) ventricular arrhythmias. The mean dermal response score immediately after removal of the 14-day ECG patch from the patients was 0.64, which indicated minimal erythema. Conclusions: The 14-day ECG patch was well tolerated and allowed for longer continuous monitoring than the 24-hour Holter monitor, thus resulting in improved clinical accuracy in the detection of paroxysmal arrhythmias. Future studies should examine the long-term effectiveness of 14-day ECG patches for managing selected patients.