Abstract 17461: Efficacy of Long-Term Monitoring on Detecting Critical Cardiac Arrhythmias

Abstract

Introduction: The ambulatory continuous ECG monitors can provide a comprehensive cardiac assessment in outpatient settings. Extended cardiac monitoring is often needed by physicians to assess the efficacy of treatment, evaluate symptoms, and to stratify patients at risk. In this study, we compare the impact of outpatient cardiac monitoring between 1-14 days and 15-30 days. Method: A retrospective analysis was done on ECG data collected from 2,679 patients using Zywie ECG monitors (Zywie, Inc., Georgia). These patients were monitored for 14-30 days. We evaluated three arrhythmias in this study: i) Atrial fibrillation (AF) of duration >15s ii) Ventricular tachycardia (VT) consisting of more than 3 heartbeats iii) Pause of duration >3s. We analyzed the first occurrence of arrhythmia episodes in every patient during their monitoring period. We identified at least one episode of AF in 486 patients, VT in 106 patients, and pause in 78 patients. Results: The incidence of the first episode of AF, VT, and pause was observed after 14 days of monitoring in 15.8%, 28.3%, and 23.1% patients, respectively (Figure 1). Furthermore, among the VT episodes, 85.3% episodes had a duration between 1-10s and 14.7% with a duration >10s. Similarly, 76% of identified pauses had a duration between 3-4s, 12% between 4-5s, and 12% with a duration >5s. Conclusion: The results demonstrate the incremental diagnostic yield of critical arrhythmic events when the monitoring is extended beyond 14 days. This study suggests that long-term outpatient monitoring can provide better diagnosis, especially for patients at a higher risk of developing critical arrhythmias.