Abstract
Background: Whether or not higher atrial fibrillation (AF) burden (% time a person is in AF) is associated with higher risk of adverse outcomes such as stroke remains controversial. Research on AF burden in community-based studies has been hampered by lead-based heart rhythm monitors that only record continuously for short durations and have poor patient compliance. Hypothesis: We hypothesized that it is feasible to use a novel leadless patch monitor (Zio ® Patch [iRhythm Technologies, Inc, San Francisco, CA] that can record continuously for 2 weeks) to investigate AF burden in a sample of MESA participants. Methods: Between November 2013 and January 2014, we included 45 (mean age, 71.6 ± 6.2 years; 58% men) participants at the Minnesota field center without prior diagnoses or symptoms suggestive of AF or other arrhythmias; 30 and 15 were randomized to self-application (Group 1) and application by MESA staff (Group 2), respectively. Monitors were mailed to Group 1 and were applied at the field centers by MESA staff for Group 2 participants. We compared the wear time and analyzable time between the 2 groups. Results: The mean and median wear and analyzable times were not significantly different between the 2 groups (Table). Only 1 participant in Group 1 wore the monitor for <2 days. Two (4%) participants were diagnosed by the monitor with AF (1 with burden of 0.02% and 1 with burden of 1.34%) and 1 with frequent non-sustained ventricular tachycardia; all participants were referred to their physicians for appropriate treatment and none suffered serious consequences. Conclusions: A leadless continuous recording patch monitor can be used effectively to investigate AF burden in asymptomatic subjects in community-based studies. Self-application of the monitor is equivalent to application by research staff which further facilitates the use of this monitor in community-based studies.
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