title: Use of a noninvasive continuous monitoring device in the management of atrial fibrillation: a pilot study.
abstract: BACKGROUND
  Outpatient ambulatory cardiac rhythm monitoring is a routine part of the management of patients with paroxysmal atrial fibrillation (AF). Current systems are limited by patient convenience and practicality.
  
  
  METHODS
  We compared the Zio(®) Patch, a single-use, noninvasive waterproof long-term continuous monitoring patch, with a 24-hour Holter monitor in 74 consecutive patients with paroxysmal AF referred for Holter monitoring for detection of arrhythmias.
  
  
  RESULTS
  The Zio(®) Patch was well tolerated, with a mean monitoring period of 10.8 ± 2.8 days (range 4-14 days). Over a 24-hour period, there was excellent agreement between the Zio(®) Patch and Holter for identifying AF events and estimating AF burden. Although there was no difference in AF burden estimated by the Zio(®) Patch and the Holter monitor, AF events were identified in 18 additional individuals, and the documented pattern of AF (persistent or paroxysmal) changed in 21 patients after Zio(®) Patch monitoring. Other clinically relevant cardiac events recorded on the Zio(®) Patch after the first 24 hours of monitoring, including symptomatic ventricular pauses, prompted referrals for pacemaker placement or changes in medications. As a result of the findings from the Zio(®) Patch, 28.4% of patients had a change in their clinical management.
  
  
  CONCLUSIONS
  The Zio(®) Patch was well tolerated, and allowed significantly longer continuous monitoring than a Holter, resulting in an improvement in clinical accuracy, the detection of potentially malignant arrhythmias, and a meaningful change in clinical management. Further studies are necessary to examine the long-term impact of the use of the Zio(®) Patch in AF management.
authors.affiliation: Division of Electrophysiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rosenberg
authors.forename: Michelle
authors.initials: M
authors.lastname: Samuel
authors.forename: Amit
authors.initials: A
authors.lastname: Thosani
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Zimetbaum
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis; D001281:Atrial Fibrillation / Q000175:diagnosis*; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects