Dzikowicz Dillon J, Aktas Mehmed, Mykins Betty, Xia Xiaojuan, Zareba Wojciech, Couderc Jean-Phillippe
School of Nursing, University of Rochester, Rochester, New York, USA.
Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York, USA.
Ann Noninvasive Electrocardiol. 2025 May;30(3):e70068. doi: 10.1111/anec.70068.
Atrial fibrillation (AF), affecting 3% of the US adults, is the most common arrhythmia. While ambulatory electrocardiogram (ECG) monitoring is essential for AF detection, conventional technologies have diagnostic limitations due to AF's sporadic nature. ECG patches offer extended monitoring periods, though their effectiveness is primarily limited by deteriorating skin-electrode contact rather than battery or memory constraints.
This analysis reports our experience with the Zio ECG patch (iRhythm, San Francisco, CA) in 256 AF patients.
We analyzed human and technical factors and their association with ECG recording duration using previously recorded data which employed the ECG patch as a reference. Descriptive statistics and logistic regression were used to identify associations.
Body mass index (BMI) was found to be an independent predictor of poorer compliance in a dose-dependent manner (B = -0.046, OR = 0.955, 95% CI: 0.916-0.996, p = 0.033). Loss of adhesive was the primary reason for poor compliance (n = 25; 11%). These findings can guide researchers and clinicians in determining the appropriateness of a 14-day ECG patch based on expected wear time and patient compliance.
BMI significantly impacts ECG patch compliance, primarily through adhesive failures. These findings indicate the need for improved adhesive technologies for higher BMI patients. Future device development should prioritize maintaining electrode-skin contact across diverse patient populations.
ClinicalTrials.gov Identifier: NCT04267133.
心房颤动（AF）影响着3%的美国成年人，是最常见的心律失常。虽然动态心电图（ECG）监测对于AF检测至关重要，但由于AF的偶发性，传统技术存在诊断局限性。ECG贴片可提供更长的监测期，不过其有效性主要受皮肤与电极接触变差的限制，而非电池或内存限制。
本分析报告了我们在256例AF患者中使用Zio ECG贴片（iRhythm，旧金山，加利福尼亚州）的经验。
我们使用先前记录的数据（以ECG贴片为参考）分析了人为因素和技术因素及其与ECG记录时长的关联。采用描述性统计和逻辑回归来确定关联。
发现体重指数（BMI）是以剂量依赖方式影响依从性较差的独立预测因素（B = -0.046，OR = 0.955，95%CI：0.916 - 0.996，p = 0.033）。粘合剂脱落是依从性差的主要原因（n = 25；11%）。这些发现可指导研究人员和临床医生根据预期佩戴时间和患者依从性来确定14天ECG贴片的适用性。
BMI主要通过粘合剂失效显著影响ECG贴片的依从性。这些发现表明需要为BMI较高的患者改进粘合剂技术。未来设备的开发应优先考虑在不同患者群体中保持电极与皮肤的接触。
ClinicalTrials.gov标识符：NCT04267133。
