Research LettersComparison of 2 ambulatory patch ECG monitors: The benefit of the P-wave and signal clarity
Section snippets
Methods
This study compared 2 FDA-approved monitors: the ZioPatch Monitor, Zio-XT (iRhythm Technologies, Inc, San Francisco, CA) and the Carnation Ambulatory Monitoring, CAM (BDx, Inc, Seattle, WA) (Figure 1).
The primary outcomes of this prospective comparative study were to compare the ECG signal clarity and to determine whether there were differences in rhythm types diagnosed between the 2 monitors. Secondary end points were whether variances in the findings on the CAM or Zio-XT resulted in
Patient demographics
Thirty consecutive patients consented to the study. Patient age was 73.1 ± 7.1 years (range 52–87), with 20 men and 10 women. One patient was found to have no data recorded on the Zio-XT upon analysis by the Zio-XT reading center, and therefore, comparative ECG analysis was available for 29 of 30 patients.
Arrhythmia inventory
A total of 86.7 ± 0.6 arrhythmias were inventoried from the Zio-XT AEM set and 121.7 ± 2.1 from the CAM AEM set, P < .001. Atrial tachycardia was the most common individual arrhythmia
Discussion
There are several important findings in our study. (1) The CAM recordings identified more episodes of atrial tachycardia, atrial flutter, and nonsustained VT compared to the Zio-XT monitor. (2) The CAM ECGs were ranked higher in clarity compared to the Zio-XT, allowing physician reviewers more confidence in making a specific rhythm diagnosis. (3) Both monitors were generally easy to apply and remove, and most patients had a good experience with both. (4) Differences in specific arrhythmias
Conclusions
This study demonstrates that differences in specific rhythm diagnosis and ECG clarity may exist between commercially available patch ambulatory ECG monitors. In this study, we found higher rhythm specificity with a CAM AEM. Further comparative studies should be performed.
For a more detailed description of the methods, results, and for more ECG examples from this clinical study, please refer to the electronic supplement accompanying this manuscript.
The following are the supplementary data
References (12)
- et al.
Comparison of diagnostic value using a small, single channel, P-wave centric sternal ECG monitoring patch with a standard 3-lead Holter system over 24 hours
Am Heart J
(2017) - et al.
Efficacy and safety of catheter ablation in octogenarians
J Am Coll Cardiol
(2000) - et al.
Relationship between burden of premature ventricular complexes and left ventricular function
Heart Rhythm J
(2010) - et al.
Spectrum and prognostic significance of arrhythmias on ambulatory Holter electrocardiogram in hypertrophic cardiomyopathy
J Am Coll Cardiol
(2005) - et al.
Nonsustained ventricular tachycardia in hypertrophic cardiomyopathy: An independent marker of sudden death risk in young patients
J Am Coll Cardiol
(2003) - et al.
Comparison of 24-hour Holter monitoring with 14-day novel adhesive patch electrocardiographic monitoring
Am J Med
(2014)