Heckbert Susan R, Austin Thomas R, Jensen Paul N, Floyd James S, Psaty Bruce M, Soliman Elsayed Z, Kronmal Richard A
Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA.
Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA.
J Electrocardiol. 2018 Nov-Dec;51(6):997-1002. doi: 10.1016/j.jelectrocard.2018.07.027. Epub 2018 Jul 30.
Patch electrocardiographic (ECG) monitors permit extended noninvasive ambulatory monitoring. To guide use of these devices, information is needed about their performance. We sought to determine in a large general population sample the acceptability of patch ECG monitors, the yield of arrhythmia detection, and the consistency of findings in participants monitored twice.
In the Multi-Ethnic Study of Atherosclerosis, 1122 participants completed one or two monitoring episodes using the Zio Patch XT, a single-channel ECG patch monitor capable of recording for 14 days. Recordings were analyzed for atrial fibrillation (AF), atrial flutter, atrioventricular block, pauses, and supraventricular and ventricular ectopy.
The mean(SD) age at the time of monitoring was 75(8) years, 52% were men, and 15% had a prior history of clinically-recognized AF/flutter. The median monitoring duration was 13.8 days. Among 804 participants with no prior clinical history of AF/flutter and at least 12 days of monitoring on a single device, AF/flutter was detected in 32 (4.0%); in 38% of these, AF/flutter was first detected during days 3 through 12 of monitoring. In participants monitored twice, findings from the two devices showed excellent agreement for supraventricular and ventricular ectopic beats per hour, but only fair agreement for high-grade atrioventricular block and pauses of >3 s duration.
In a general population of older individuals, new diagnoses of AF/flutter were made in 4.0% of participants without a prior history. A single monitoring episode accurately estimated rates of supraventricular and ventricular ectopy.
贴片式心电图（ECG）监测仪可实现长时间的无创动态监测。为指导这些设备的使用，需要了解其性能信息。我们试图在一个大型普通人群样本中确定贴片式ECG监测仪的可接受性、心律失常检测的阳性率以及在接受两次监测的参与者中结果的一致性。
在动脉粥样硬化多民族研究中，1122名参与者使用Zio Patch XT完成了一次或两次监测，这是一种能够记录14天的单通道ECG贴片监测仪。对记录进行分析，以检测心房颤动（AF）、心房扑动、房室传导阻滞、停搏以及室上性和室性早搏。
监测时的平均（标准差）年龄为75（8）岁，52%为男性，15%有临床诊断的AF/扑动病史。中位监测时长为13.8天。在804名无AF/扑动临床病史且在单一设备上至少监测12天的参与者中，检测到AF/扑动的有32例（4.0%）；其中38%的AF/扑动是在监测的第3至12天首次检测到的。在接受两次监测的参与者中，两台设备对于每小时室上性和室性早搏的结果显示出极好的一致性，但对于高度房室传导阻滞和持续时间>3秒的停搏，一致性仅为一般。
在老年普通人群中，4.0%无前病史的参与者被新诊断出AF/扑动。单次监测能够准确估计室上性和室性早搏的发生率。
