Please login or register to print this page.

Clinical Articles, Lead Article

Patch outperforms Holter for prolonged heart rhythm tracking

A small adhesive wireless device worn on the chest for up to two weeks does a better job detecting arrhythmias than the Holter monitor, according to research published recently in the American Journal of Medicine.1

The patch (Zio®, iRhythm) is a USA Food and Drug Administration-cleared compact, low-profile, noninvasive, water-resistant device that is worn for up to two weeks throughout normal activity then mailed by the patient to a centre for data analysis with a proprietary algorithm.

The Scripps Translational Science Institute (STSI) study used electrocardiograph data collected from 146 patients who were fitted with a patch and a Holter monitor after being referred to the cardiac investigations laboratory at Scripps Green Hospital for ambulatory heart monitoring. The Holter monitor was worn for 24 hours, and the patch was worn for up to 14 days.

Over the course of the study, the patch detected 96 arrhythmia events while the Holter monitor detected 61. The researchers credited the patch’s superior performance primarily to prolonged monitoring.

Physicians who reviewed data from both devices reported reaching a definitive diagnosis 90% of the time when using the patch results and 64% of the time when using Holter monitor data. A survey of study participants found that 81 percent of them preferred wearing the patch over the Holter monitor, with 76% saying the Holter monitor affected their daily living activities.

One unexpected finding was that the Holter monitor detected 11 more arrhythmias than the patch during the initial 24 hour period when both devices were working simultaneously. However, all of those arrhythmias were picked beyond 24 hours by the patch during the device’s extended monitoring period. The patch detected two arrhythmias not captured by the Holter during the initial 24 hour period.

“This is the first large prospective validation that this new technology superseded the device invented by Norman Holter in 1949,” said study senior author Dr Eric Topol. “By tracking every heart beat for up to two weeks, the [patch] proved to be significantly more sensitive than the standard Holter, which uses multiple wires and typically is only used or tolerated for 24 hours.”

“For millions of people who present each year with suspected arrhythmia, this may prove to be the new standard for capturing the culprit heart rhythm electrical disturbance, most commonly atrial fibrillation which carries a significant risk of stroke,” Dr Topol said.

References

1. 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 2014;127:95.e11–95.e17. http://dx.doi.org/10.1016/j.amjmed.2013.10.003

Published on: March 28, 2014

Members Area

Log in or Register now.

 For healthcare professionals only
Learning sky

SEARCH THE SITE

RSS FEED

Subscribe to our RSS feed
home

GET EXCLUSIVE UPDATES

Sign up for our regular email newsletters & be the first to know about fresh articles and site updates.

RECENT COMMENTS

    None Found

ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

You are not logged in

You need to be a member to print this page.
Sign up for free membership, or log in.

You are not logged in

You need to be a member to download PDF's.
Sign up for free membership, or log in.