Comparison of continuous 24-hour and 14-day ECG monitoring for the detection of cardiac arrhythmias in patients with...

Area of Science:

• Cardiology
• Neurology
• Medical Devices

Background:

• Conventional 12-lead or 24-hour electrocardiogram (ECG) monitoring is often insufficient for detecting cardiac arrhythmias in patients experiencing stroke or syncope.
• Identifying the underlying cause of these events is crucial for effective patient management and preventing future occurrences.

Purpose of the Study:

• To evaluate the diagnostic yield of a 14-day continuous ECG patch compared to a standard 24-hour Holter monitor for arrhythmia detection.
• To assess the efficacy of the 14-day ECG patch in patients with newly diagnosed ischemic stroke or syncope.

Main Methods:

• A cross-sectional study involving 83 patients diagnosed with ischemic stroke or syncope.
• Patients underwent both 24-hour ECG monitoring and 14-day continuous cardiac monitoring patch application.
• Arrhythmia events detected by both monitoring methods were recorded and compared.

Main Results:

• The 14-day ECG patch demonstrated a significantly higher detection rate for composite cardiac arrhythmias (69.9%) versus the 24-hour Holter monitor (21.7%, p=0.006).
• Specific arrhythmias detected by the 14-day patch in ischemic stroke patients included supraventricular tachycardia (SVT), ventricular tachycardia (VT), atrial fibrillation (AF), atrioventricular block (AVB), and pauses.
• Significant differences in detection rates for SVT, AF, pauses, AVB, and VT were observed with the 14-day patch, but not with the 24-hour monitor.

Conclusions:

• The 14-day ECG patch is a superior tool for the early detection of cardiac arrhythmias, including atrial fibrillation, in patients with ischemic stroke or syncope.
• This extended monitoring capability can assist physicians in tailoring medical or mechanical interventions for patients, particularly those with cryptogenic stroke and occult atrial fibrillation.