Yield and consistency of arrhythmia detection with patch electrocardiographic monitoring: the Multi-Ethnic Study of Atherosclerosis
Open accessAbstract
Background Patch electrocardiographic (ECG) monitors permit extended noninvasive ambulatory monitoring. To guide use of these devices, information is needed about their performance. We sought to determine in a large general population sample the acceptability of patch ECG monitors, the yield of arrhythmia detection, and the consistency of findings in participants monitored twice.Methods In the Multi-Ethnic Study of Atherosclerosis, 1122 participants completed one or two monitoring episodes using the Zio Patch XT, a single-channel ECG patch monitor capable of recording for 14 days. Recordings were analyzed for atrial fibrillation (AF), atrial flutter, atrioventricular block, pauses, and supraventricular and ventricular ectopy.Results The mean(SD) age at the time of monitoring was 75(8) years, 52% were men, and 15% had a prior history of clinically-recognized AF/flutter. The median monitoring duration was 13.8 days. Among 804 participants with no prior clinical history of AF/flutter and at least 12 days of monitoring on a single device, AF/flutter was detected in 32 (4.0%); in 38% of these, AF/flutter was first detected during days 3 through 12 of monitoring. In participants monitored twice, findings from the two devices showed excellent agreement for supraventricular and ventricular ectopic beats per hour, but only fair agreement for high-grade atrioventricular block and pauses of >3 s duration.Conclusions In a general population of older individuals, new diagnoses of AF/flutter were made in 4.0% of participants without a prior history. A single monitoring episode accurately estimated rates of supraventricular and ventricular ectopy.
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Even ECG patch monitors, praised for high patient compliance, are limited to 14-day recording.
“Even ECG patch monitors, praised for high patient compliance, are limited to 14-day recording [6].”
From Modeling of artifacts in the wrist photoplethysmogram: Application to the detection of life-threatening arrhythmias (2021) · cites this paper as [6]
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- Authors
- Heckbert, S. R., Austin, T. R., Jensen, P. N., Floyd, J. S., Psaty, B. M., Soliman, E. Z., & Kronmal, R. A.
- Affiliations
- University of Washington (US)
- Kaiser Permanente Washington Health Research Institute (US)
- Wake Forest University Health Sciences (US)
- Corresponding author
- Heckbert, Susan R.
- ORCID
- Venue
- Journal of Electrocardiology
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 51
- Issue
- 6
- Pages
- 997-1002
- ISSN
- 0022-0736 (ISSN-L)
- PMC
- PMC6278608
- OpenAlex
- W2886994210
- Cited by
- 72
- References
- 11
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 8 · 2023: 10 · 2022: 12 · 2021: 22 · 2020: 7 · 2019: 5
- FWCI
- 6.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Electrocardiology (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Johnson and Johnson
- National Heart, Lung, and Blood Institute (N01-HC-95164, N01-HC-95167, R01 HL127659, N01-HC-95160, N01-HC-95159, N01-HC-95168, N01-HC-95162, N01-HC-95165, HHSN268201500003I, N01-HC-95163, N01-HC-95166, N01-HC-95169, N01-HC-95161)
- National Institutes of Health
- National Center for Advancing Translational Sciences (UL1-TR-000040, UL1-TR-001079, UL1-TR-001420)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Keywords
- arrhythmia detection, atrial fibrillation, atrial flutter, atrioventricular block, extrasystoles, Holter monitoring, diagnostic yield, inter-device agreement, older adults, Multi-Ethnic Study of Atherosclerosis
- MeSH terms
- Aged, Aged, 80 and over, Atrial Fibrillation, Atrial Flutter, Female, Humans, Male, Mass Screening, Middle Aged, United States, Electrocardiography, Ambulatory, Ventricular Premature Complexes, Atherosclerosis, Atrioventricular Block
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