Comparison of 24 h ECG Holter Monitoring with Real-time Long-term ECG Monitoring System using ECGalert Software and Savvy Single-Lead Patch
DOI:
https://doi.org/10.3889/oamjms.2021.4960Keywords:
Atrial fibrillation, Cardiac arrhythmias, Electrocardiography, ECG Holter monitoring, ECGalert, SavvyAbstract
AIM: The aim of the study was to show non-inferiority of the single-channel ECGalert system to the gold standard (ECG Holter) in the detection of arrhythmias over the total wear time of both devices.
METHODS: A prospective study enrolled a total of 165 patients hospitalized at the University Clinic of Cardiology, who underwent simultaneous single-channel ECG recording with ECGAlert system and a conventional 24 h Holter monitor on the 1st day and continued ECGAlert monitoring for few more days, under assignment of the doctor or at the wish of the patient.
RESULTS: A total of 165 patients were included in the study, 61.2% male, mean age of 58.4 ± 12.7 years. Mean duration of ECG Holter monitoring was 23.2 ± 0.5 h and mean duration of ECGalert/Savvy monitoring was 64.6 ± 31.2. During the first 24 h of simultaneous ECG monitoring with both methods, no statistically significant difference was found in arrhythmia detection. Over the total wear time of both devices, the ECGalert system detected significantly more AF episodes as compared to Holter (p < 0.000). ECGalert demonstrated significantly lower detection rate of false pauses (0.001). However, false detection of episodes of VT or AF was significantly higher in ECGalert system versus Holter (p < 0.000 and p < 0.000 respectively). Patients were more satisfied with ECGalert system, due to lesser interference in daily activities.
CONCLUSION: The ECGalert system demonstrated superiority over traditional Holter monitoring in arrhythmia detection in the total monitoring period, but not in the first 24 h.
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References
Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(38):2893-962. PMid:27567408
Kaleschke G, Hoffmann B, Drewitz I, Steinbeck G, Naebauer M, Goette A, Breithardt G, et al. Prospective, multicentre validation of a simple, patientoperated electrocardiographic system for the detection of arrhythmias and electrocardiographic changes. Europace. 2009;11(10):1362-8. https://doi.org/10.1093/europace/eup262 PMid:19797150
Tieleman RG, Plantinga Y, Rinkes D, Bartels GL, Posma JL, Cator R, et al. Validation and clinical use of a novel diagnostic device for screening of atrial fibrillation. Europace 2014;16:1291-5. https://doi.org/10.1093/europace/euu057 PMid:24825766
Barrett PM, Komatireddy R, Haaser S, Topol S, Sheard J, Encinas J, et al. Comparison of 24-hour Holter monitoring with 14-day novel adhesive patch electrocardiographic monitoring. Am J Med. 2014;127(1):95.e11-7. https://doi.org/10.1016/j.amjmed.2013.10.003 PMid:24384108
Ajdaraga E, Gusev M, Poposka L. Evaluation of User Satisfaction with the ECGalert System. 2019 42nd International Convention on Information and Communication Technology, Electronics and Microelectronics (MIPRO). New Jersey: Institute of Electrical and Electronics Engineers; 2019. https://doi.org/10.23919/mipro.2019.8756722
Steinhubl SR, Waalen J, Edwards AM, Ariniello LM, Mehta RR, Ebner GS, et al. Effect of a home-based wearable continuous ECG monitoring patch on detection of undiagnosed atrial fibrillation: The mSToPS randomized clinical trial. JAMA. 2018;320(2):146-55. https://doi.org/10.1001/jama.2018.8102 PMid:29998336
Zimetbaum PJ, Kim KY, Josephson ME, Goldberger AL, Cohen DJ. Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations. A cost-effectiveness analysis. Ann Intern Med. 1998;128(11):890-5. https://doi.org/10.7326/0003-4819-128-11-199806010-00002 PMid:9634426
Lau JK, Lowres N, Neubeck L, Brieger DB, Sy RW, Galloway CD, et al. iPhone ECG application for community screening to detect sillent atrial fibrillation: A novel technology to prevent stroke. Int J Cardiol. 2013;165(1):193-4. https://doi.org/10.1016/j.ijcard.2013.01.220 PMid:23465249
Lowres N, Neubeck L, Salkeld G, Krass I, McLachlan AJ, Redfern J, et al. Feasibility and cost-effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies The SEARCH-AF study. Thromb Haemost. 2014;111(6):1167-76. https://doi.org/10.1160/th14-03-0231 PMid:24687081
Gusev M, Poposka L, Guseva E. Applicability of the ECGalert Solution. 2017, 25th Telecommunication Forum (TELFOR). New Jersey: Institute of Electrical and Electronics Engineers; 2017. https://doi.org/10.1109/telfor.2017.8249437
Locati ET, Vecchi AM, Vargiu S, Cattafi G, Lunati M. Role of extended external loop recorders for the diagnosis of unexplained syncope, pre-syncope, and sustained palpitations. Europace. 2014;16(6):914-22. https://doi.org/10.1093/europace/eut337 PMid:24158255
Mlynarczyk J, Poreba M, Gac P, Derkacz A, Brylka A, Jurdziak M, et al. Significance of external loop recorders (ELR) in diagnosis of disturbances in heart rhythm. Fam Med Prim Care Rev. 2015;17(3):193-6. https://doi.org/10.5114/fmpcr/45093
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Copyright (c) 2021 Lidija Poposka, Marija Vavlukis, Hristo Pejkov, Marjan Gusev (Author)
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