Tung Christie E, Su Derek, Turakhia Mintu P, Lansberg Maarten G
Department of Neurology, Stanford University , Palo Alto, CA , USA.
Division of Cardiovascular Medicine, Department of Medicine, Stanford University , Palo Alto, CA , USA ; Veterans Affairs Palo Alto Health Care System , Palo Alto, CA , USA.
Front Neurol. 2015 Jan 12;5:266. doi: 10.3389/fneur.2014.00266. eCollection 2014.
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.
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.
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.
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.
对于短暂性脑缺血发作（TIA）或中风患者，评估其是否患有心房颤动（AF）非常重要，因为检测到AF会改变推荐的抗血栓治疗方案，即从使用抗血小板药物治疗改为口服抗凝治疗。本研究描述了一种基于贴片、一次性使用且防水的14天连续心律监测器（ZIO贴片）在中风或TIA患者中的诊断效能。
我们从ZIO贴片（iRhythm Technologies）的制造商和服务商获取了数据。纳入2012年1月至2013年6月期间接受监测且监测指征为TIA或中风的患者。记录监测时长、心律失常的数量和类型以及首次出现心律失常的时间。
分析了1171份监测报告。平均监测佩戴时间为10.9天，中位佩戴时间为13.0天（四分位间距7.2 - 14.0）。相对于总佩戴时间的中位可分析时间为98.7%（四分位间距96.0 - 99.5%）。所有报告中有5.0%存在AF。阵发性房颤（PAF）首次发作前的平均时长为1.5天，中位时长为0.4天。14.3%的首次PAF发作发生在48小时之后。PAF平均负担占总监测时长的12.7%。
记录质量优异、患者依从性良好，且在监测的48小时之后检测到相当比例的AF，这表明对于中风或TIA患者，心脏贴片在检测AF方面优于传统的48小时动态心电图监测仪。
