title: Comparison of 24-hour Holter monitoring with 14-day novel adhesive patch electrocardiographic monitoring.
abstract: BACKGROUND
  Cardiac arrhythmias are remarkably common and routinely go undiagnosed because they are often transient and asymptomatic. Effective diagnosis and treatment can substantially reduce the morbidity and mortality associated with cardiac arrhythmias. The Zio Patch (iRhythm Technologies, Inc, San Francisco, Calif) is a novel, single-lead electrocardiographic (ECG), lightweight, Food and Drug Administration-cleared, continuously recording ambulatory adhesive patch monitor suitable for detecting cardiac arrhythmias in patients referred for ambulatory ECG monitoring.
  
  
  METHODS
  A total of 146 patients referred for evaluation of cardiac arrhythmia underwent simultaneous ambulatory ECG recording with a conventional 24-hour Holter monitor and a 14-day adhesive patch monitor. The primary outcome of the study was to compare the detection arrhythmia events over total wear time for both devices. Arrhythmia events were defined as detection of any 1 of 6 arrhythmias, including supraventricular tachycardia, atrial fibrillation/flutter, pause greater than 3 seconds, atrioventricular block, ventricular tachycardia, or polymorphic ventricular tachycardia/ventricular fibrillation. McNemar's tests were used to compare the matched pairs of data from the Holter and the adhesive patch monitor.
  
  
  RESULTS
  Over the total wear time of both devices, the adhesive patch monitor detected 96 arrhythmia events compared with 61 arrhythmia events by the Holter monitor (P < .001).
  
  
  CONCLUSIONS
  Over the total wear time of both devices, the adhesive patch monitor detected more events than the Holter monitor. Prolonged duration monitoring for detection of arrhythmia events using single-lead, less-obtrusive, adhesive-patch monitoring platforms could replace conventional Holter monitoring in patients referred for ambulatory ECG monitoring.
authors.affiliation: Scripps Translational Science Institute, La Jolla, Calif.
authors.forename: Paddy M
authors.initials: PM
authors.lastname: Barrett
authors.affiliation: Scripps Translational Science Institute, La Jolla, Calif.
authors.forename: Ravi
authors.initials: R
authors.lastname: Komatireddy
authors.affiliation: Scripps Translational Science Institute, La Jolla, Calif.
authors.forename: Sharon
authors.initials: S
authors.lastname: Haaser
authors.affiliation: Scripps Translational Science Institute, La Jolla, Calif.
authors.forename: Sarah
authors.initials: S
authors.lastname: Topol
authors.affiliation: Scripps Translational Science Institute, La Jolla, Calif.
authors.forename: Judith
authors.initials: J
authors.lastname: Sheard
authors.affiliation: Scripps Translational Science Institute, La Jolla, Calif.
authors.forename: Jackie
authors.initials: J
authors.lastname: Encinas
authors.affiliation: Fought Statistical Consulting, Chicago, Ill.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Fought
authors.affiliation: Scripps Translational Science Institute, La Jolla, Calif; Scripps Health, La Jolla, Calif. Electronic address: etopol@scripps.edu.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Topol
mesh_terms: D000269:Adhesives; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000175:diagnosis; D001282:Atrial Flutter / Q000175:diagnosis; D054537:Atrioventricular Block / Q000175:diagnosis; D004562:Electrocardiography / Q000379:methods*; D015716:Electrocardiography, Ambulatory; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D013617:Tachycardia, Supraventricular / Q000175:diagnosis; D017180:Tachycardia, Ventricular / Q000175:diagnosis; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000175:diagnosis
chemical_list: D000269:Adhesives
keywords: Atrial fibrillation; Cardiac arrhythmias; Electrocardiographic; Holter monitor; Zio Patch; iRhythm