Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Int J Cardiol. 2021 Jun 1;332:78-84. doi: 10.1016/j.ijcard.2021.03.015. Epub 2021 Mar 13.
To evaluate the performance of a single‑lead, 14-day continuous electrocardiogram (ECG) patch for the detection of arrhythmias compared to conventional 24-h monitoring.
This prospective clinical trial enrolled patients suspected of arrhythmias but not diagnosed by 12‑lead ECGs. Each patient underwent a 24-h Holter and 14-day ECG patch simultaneously. Seven types of arrhythmias were classified: supraventricular tachycardia (SVT, repetitive atrial beats >4 beats), irregular SVT without P wave (>4 beats), AF/AFL (irregular SVT without P wave ≥30 s), pause ≥3 s, atrioventricular block (AVB; Mobitz type II, third-degree, two to one or high degree AVB), ventricular tachycardia (VT), and polymorphic VT.
A total of 158 patients were recruited (mean wear time:12.3 ± 3.2 days). The overall arrhythmia detection rate was higher with 14-day ECG patches (59.5%) compared to 24-h Holter (19.0%, P < 0.001). Up to 87.2% of arrhythmias recorded with 14-day ECG patches were not associated with symptoms. The 14-day ECG patch was associated with higher detection rates compared to the 24-h Holter in patients with SVT (52.5% versus 15.8%, P < 0.001), irregular SVT without P wave (12.7% versus 4.4%, P = 0.002), AF/AFL (9.5% versus 3.8%, P = 0.042), and critical arrhythmias (pause ≥3 s, AVB, VT, polymorphic VT) (16.5% versus 2.5%, P < 0.001). The 14-day ECG patch detected more than 2 types of arrhythmias in 5.1% of patients. No serious adverse events in patients wearing the 14-day ECG patch were reported.
The 14-day ECG patch outperformed 24-h Holter to detect overall, asymptomatic, critical and multiple arrhythmias. It is safe and has the potential to identify individuals with hidden arrhythmias, especially those with critical arrhythmias.
评估单导联、14 天连续心电图（ECG）贴片在检测心律失常方面的性能，与传统 24 小时监测相比。
这项前瞻性临床试验招募了疑似心律失常但 12 导联心电图检查未确诊的患者。每位患者同时进行 24 小时动态心电图和 14 天心电图贴片检查。将七种类型的心律失常进行分类：室上性心动过速（SVT，重复心房搏动>4 次）、无 P 波的不规则 SVT（>4 次）、AF/AFL（无 P 波的不规则 SVT≥30 秒）、≥3 秒的停搏、房室传导阻滞（AVB；Mobitz Ⅱ型、三度、二比一或高度 AVB）、室性心动过速（VT）和多形性 VT。
共纳入 158 例患者（平均佩戴时间：12.3±3.2 天）。14 天心电图贴片的整体心律失常检测率（59.5%）高于 24 小时动态心电图（19.0%，P<0.001）。高达 87.2%的 14 天心电图贴片记录的心律失常与症状无关。与 24 小时动态心电图相比，14 天心电图贴片在 SVT（52.5%比 15.8%，P<0.001）、无 P 波的不规则 SVT（12.7%比 4.4%，P=0.002）、AF/AFL（9.5%比 3.8%，P=0.042）和危急心律失常（≥3 秒停搏、AVB、VT、多形性 VT）（16.5%比 2.5%，P<0.001）方面的检测率更高。14 天心电图贴片在 5.1%的患者中检测到超过 2 种心律失常。佩戴 14 天心电图贴片的患者未报告严重不良事件。
14 天心电图贴片在检测整体、无症状、危急和多种心律失常方面优于 24 小时动态心电图。它是安全的，有潜力识别隐匿性心律失常患者，尤其是危急心律失常患者。
