Chronic Ambulatory Monitoring: Results of a Large Single-Center Experience

EisenbErg, E., et al. (2014)

THE Journal of Innovations in Cardiac Management

Introduction: Non-invasive, leadless monitoring patches capable of continuous longterm electrocardiogram (ECG) recording are now available for rhythm surveillance. This technology has the potential to greatly impact our understanding of arrhythmias occurring in the ambulatory setting.

Methods: We reviewed data obtained from 524 consecutive patients referred to an academic electrophysiology practice and prescribed a leadless monitoring device. Patients were instructed to wear the device for up to 14 days and to activate a trigger button on the device when they experienced symptoms.

Results: Overall, 99% of patients had some recorded arrhythmia. The most common was a ventricular premature beat (93%). The most common significant arrhythmia was supraventricular tachycardia in 231 patients (44%), followed by atrial fibrillation/flutter (AF) in 105 patients (20%), and non-sustained ventricular tachycardia in 79 patients (15%). Over one-third of initial arrhythmias were recorded after 48 h. The most common rhythm associated with patient triggered symptoms was normal sinus (50%). The most accurately reported symptomatic arrhythmia was AF; however, the majority of AF episodes (62%) were asymptomatic.

Conclusion: Long-term ECG monitoring detected arrhythmias in all subjects, and a large percentage were detected after 48 h. Patient-reported symptoms do not correlate with arrhythmias, including AF, in half of all symptom recordings.