title: Diagnostic Yield of Extended Cardiac Patch Monitoring in Patients with Stroke or TIA.
abstract: BACKGROUND
  It is important to evaluate patients with transient ischemic attack (TIA) or stroke for atrial fibrillation (AF) because the detection of AF changes the recommended anti-thrombotic regimen from treatment with an antiplatelet agent to oral anticoagulation. This study describes the diagnostic yield of a patch-based, single-use, and water-resistant 14-day continuous cardiac rhythm monitor (ZIO Patch) in patients with stroke or TIA.
  
  
  METHODS
  We obtained data from the manufacturer and servicer of the ZIO Patch (iRhythm Technologies). Patients who were monitored between January 2012 and June 2013 and whose indication for monitoring was TIA or stroke were included. The duration of monitoring, the number and type of arrhythmias, and the time to first arrhythmia were documented.
  
  
  RESULTS
  One thousand one hundred seventy-one monitoring reports were analyzed. The mean monitor wear time was 10.9 days and the median wear time was 13.0 days (interquartile range 7.2-14.0). The median analyzable time relative to the total wear time was 98.7% (IQR 96.0-99.5%). AF was present in 5.0% of all reports. The mean duration before the first episode of paroxysmal AF (PAF) was 1.5 days and the median duration was 0.4 days. 14.3% of first PAF episodes occurred after 48 h. The mean PAF burden was 12.7% of the total monitoring duration.
  
  
  CONCLUSIONS
  Excellent quality of the recordings and very good patient compliance coupled with a substantial proportion of AF detection beyond the first 48 h of monitoring suggest that the cardiac patch is superior to conventional 48-h Holter monitors for AF detection in patients with stroke or TIA.
authors: Department of Neurology, Stanford University , Palo Alto, CA , USA.
authors: Christie E
authors: CE
authors: Tung
authors: Department of Neurology, Stanford University , Palo Alto, CA , USA.
authors: Derek
authors: D
authors: Su
authors: Division of Cardiovascular Medicine, Department of Medicine, Stanford University , Palo Alto, CA , USA ; Veterans Affairs Palo Alto Health Care System , Palo Alto, CA , USA.
authors: Mintu P
authors: MP
authors: Turakhia
authors: Department of Neurology, Stanford University , Palo Alto, CA , USA.
authors: Maarten G
authors: MG
authors: Lansberg
keywords: SVT; TIA; arrhythmias; atrial fibrillation; cardiac; cardiac monitoring; stroke; telemetry
references: N Engl J Med. 2014 Jun 26;370(26):2467-77
references: 24963566
references: Stroke. 2014 Feb;45(2):520-6
references: 24385275
references: J Electrocardiol. 2012 Mar;45(2):148-53
references: 22153334
references: Circulation. 2014 May 27;129(21):2094-9
references: 24633881
references: Am J Cardiol. 2013 Aug 15;112(4):520-4
references: 23672988
references: N Engl J Med. 2012 Jan 12;366(2):120-9
references: 22236222
references: J Cardiovasc Electrophysiol. 2007 Mar;18(3):241-7
references: 17318994
references: N Engl J Med. 2014 Jun 26;370(26):2478-86
references: 24963567
references: Stroke. 2010 Feb;41(2):256-60
references: 20044517
references: Stroke. 2014 Jul;45(7):2160-236
references: 24788967
references: Circulation. 2010 May 4;121(17):1904-11
references: 20404258