Comparing 14-day Adhesive Patch With 24-h Holter Monitoring
Abstract
Barrett PM, Komatireddy R, Haaser S et al. Comparison of 24-hour Holter monitoring with 14-day novel adhesive patch electrocardiographic monitoring. Am. J. Med. 127(1), 95.e11–95.e17 (2014). The investigation of cardiac arrhythmias in the outpatient ambulatory setting has traditionally been initiated with the Holter monitor. Using the continuous recording over 24 or 48 h, the Holter monitor permits the detection of baseline rhythm, dysrhythmia and conduction abnormalities, including heart block and changes in the ST segment that may indicate myocardial ischemia. However, apart from the bulkiness and inconvenience of the device itself, the lack of extended monitoring results in a diagnostic yield of typically less than 20%. In this study by Barrett et al., 146 patients referred for the evaluation of cardiac arrhythmia were prospectively enrolled to wear both the 24-h Holter monitor and 14-day adhesive patch monitor (Zio Patch) simultaneously. The primary outcome was the detection of any one of six arrhythmias: supraventricular tachycardia, atrial fibrillation/flutter, pause >3 s, atrioventricular block, ventricular tachycardia, or polymorphic ventricular tachycardia/fibrillation. The adhesive patch monitor detected more arrhythmia events compared with the Holter monitor over the total wear time (96 vs. 61 events; p < 0.001), although the Holter monitor detected more events during the initial 24-h monitoring period (61 vs. 52 events; p = 0.013). Novel, single-lead, intermediate-duration, user-friendly adhesive patch monitoring devices, such as the Zio Patch, represent the changing face of ambulatory ECG monitoring. However, the loss of quality, automated rhythm analysis and inability to detect myocardial ischemia continue to remain important issues that will need to be addressed prior to the implementation of these new devices.
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If patients are referred to cardiology services, investigation usually starts with a Holter monitor but non-compliance and lack of extended monitoring reduces diagnostic yield to less than 20%.
“If patients are referred to cardiology services for assessment, investigation usually starts with a Holter monitor but non-compliance and lack of extended monitoring reduces diagnostic yield to less than 20% [11].”
From Multi-centre Randomised Controlled Trial of a Smartphone-based Event Recorder Alongside Standard Care Versus Standard Care for Patients Presenting to the Emergency Department with Palpitations and Pre-syncope: The IPED (Investigation of Palpitations in the ED) study (2019) · cites this paper as [11]
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- Authors
- Cheung, C. C., Kerr, C. R., & Krahn, A. D.
- Affiliations
- Arrhythmia Service 9th Floor Gordon & Leslie Diamond Health Care Centre 2775 Laurel Street Vancouver BC V5Z 1M9 Canada
- Venue
- Future Cardiology
- Publisher
- Informa UK Limited
- Published
- 2014-05
- Volume
- 10
- Issue
- 3
- Pages
- 319-322
- ISSN
- 1479-6678 (ISSN-L)
- 1744-8298
- OpenAlex
- W2149007105
- Semantic Scholar
- 449ac1ddc8e7e3bfa19382f2136346b82973fff3
- Cited by
- 46
- References
- 13
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 9 · 2020: 3 · 2019: 9 · 2018: 6 · 2017: 4 · 2015: 2 · 2014: 1
- FWCI
- 1.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Future Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- 24-hour Holter monitoring, Holter monitoring, arrhythmia detection, supraventricular tachycardia, atrial fibrillation, ventricular tachycardia, atrioventricular block, myocardial ischemia detection, single-lead ECG
- MeSH terms
- Arrhythmias, Cardiac, Electrocardiography, Female, Humans, Male, Electrocardiography, Ambulatory
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