Kim Yun Gi, Choi Jong-Il, Oh Il-Young, Jeong Joo Hee, Lee Hyoung Seok, Choi Yun Young, Lee Ji Hyun, Cho Youngjin, Shim Jaemin, Son Ho Sung, Kim Young-Hoon
Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Anam Hospital, Seoul, Korea.
Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Korea.
J Korean Med Sci. 2025 Jul 21;40(28):e168. doi: 10.3346/jkms.2025.40.e168.
Patch-electrocardiography (ECG) enables prolonged ECG monitoring beyond 24 hours. However, diagnostic yield between patch-ECG and Holter monitoring needs further validation. We aimed to compare diagnostic capabilities of 14-day patch-ECG and one day Holter monitoring to detect cardiac arrhythmias.
Patients with suspected cardiac arrhythmias but could not be diagnosed by 12-lead ECG were enrolled from two tertiary centers. Patch-ECG and Holter monitoring was attached simultaneously in enrolled patients. Primary endpoint was detection of major arrhythmias which was defined as atrial fibrillation (AF), atrial tachycardia, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), ventricular tachycardia, 2nd or 3rd degree atrioventricular block, sick pause (> 2 seconds of pause), sick sinus syndrome, tachycardia-bradycardia syndrome, and Wolff-Parkinson-White syndrome.
A total of 147 patients were analyzed. Major arrhythmias were detected in 75.5% and 48.3% in patch-ECG and Holter monitoring, respectively ( < 0.001). Detection rate between the first day of patch-ECG and Holter monitoring was identical. Detection rate for AF was significantly higher in patch-ECG (23.8% vs. 11.6%; < 0.001). Substantial proportion of AF events were detected in the first day of monitoring (42.9%) but diagnosis rate increased steadily between day 2-14 of monitoring. Detection rate of supraventricular tachycardia (atrial tachycardia or PSVT), ventricular tachycardia, and brady-arrhythmias was higher in the patch-ECG. Four patients had to detach their patch-ECG due to skin side effects.
Patch-ECG has higher diagnostic capabilities compared to Holter monitoring for diagnosis of various cardiac arrhythmias.
贴片式心电图（ECG）能够进行超过24小时的长时间心电图监测。然而，贴片式心电图与动态心电图监测之间的诊断率仍需进一步验证。我们旨在比较14天贴片式心电图和1天动态心电图监测检测心律失常的诊断能力。
从两个三级中心招募疑似心律失常但无法通过12导联心电图确诊的患者。在入选患者中同时进行贴片式心电图和动态心电图监测。主要终点是检测主要心律失常，定义为心房颤动（AF）、房性心动过速、心房扑动、阵发性室上性心动过速（PSVT）、室性心动过速、二度或三度房室传导阻滞、病态窦房结综合征（>2秒的停搏）、心动过速-心动过缓综合征和预激综合征。
共分析了147例患者。贴片式心电图和动态心电图监测分别检测到75.5%和48.3%的主要心律失常（<0.001）。贴片式心电图第一天和动态心电图监测的检测率相同。贴片式心电图中AF的检测率显著更高（23.8%对11.6%；<0.001）。在监测的第一天检测到相当比例的AF事件（42.9%），但在监测的第2 - 14天诊断率稳步上升。贴片式心电图中室上性心动过速（房性心动过速或PSVT）、室性心动过速和缓慢性心律失常的检测率更高。4例患者因皮肤副作用不得不取下贴片式心电图。
与动态心电图监测相比，贴片式心电图在诊断各种心律失常方面具有更高的诊断能力。
