The Zio Patch provided longer continuous monitoring than a Holter monitor, identifying AF events in 18 additional patients and changing clinical management in 28.4% of patients.
Observational (n=74)
Does the Zio Patch improve the detection of atrial fibrillation events and change clinical management compared to a 24-hour Holter monitor in patients with paroxysmal AF?
Extended continuous ambulatory monitoring with the Zio Patch significantly increases the detection of arrhythmias and leads to meaningful changes in clinical management compared to standard 24-hour Holter monitoring.
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.
Rosenberg et al. (2012) conducted an observational in paroxysmal atrial fibrillation (n=74). Zio Patch vs. 24-hour Holter monitor was evaluated on identification of AF events and estimation of AF burden. The Zio Patch provided longer continuous monitoring than a Holter monitor, identifying AF events in 18 additional patients and changing clinical management in 28.4% of patients.