Abstract
Background: Holter electrocardiogram (ECG) is the gold standard for ambulatory monitoring of atrial fibrillation (AF) but it is insufficient because of its limited recording time. A wearable ECG with a medical-grade dry textile electrode is a promising technology to remedy this limitation. This pilot study aimed to simultaneously compare the wearable and Holter ECGs for ambulatory monitoring in a clinical setting. Methods: This prospective observational study enrolled 18 patients who underwent AF ablation. One day after AF ablation, ambulatory ECG was obtained for three hours simultaneously using both the wearable and Holter ECG devices. Automatic ECG interpretations between devices were compared with correlation and agreement analyses. Results: Simultaneous ECG monitoring demonstrated a comparable analysis time and total heart beats between the two devices. Almost complete correlation and agreement were also demonstrated in all clinically relevant testing aspects except in R-wave amplitude (r = 0.743, p < .001). AF was detected in three patients. AF duration was the same in both ECG devices in two patients with continuous AF. In the remaining patient with intermittent AF, AF duration was shortened by 0.6% with the wearable ECG as compared to that with the Holter ECG. Conclusions: Simultaneous ECG comparison revealed a high consistency between the wearable and Holter ECG devices. The results of this study warrant further clinical studies for long-term monitoring of ambulatory ECG after AF ablation.
Highlights
Atrial fibrillation (AF) is the most prevalent form of arrhythmia with an increasing incident worldwide; it is associated with an increased lifetime risk of stroke, heart failure, myocardial infarction, dementia, and mortality.[1,2] Whether atrial fibrillation (AF) presents or not is crucial for making a clinical decision regarding treatment strategy
Long-term monitoring with an electrocardiogram (ECG) is essential for the management of AF, which can present with short and silent forms, especially those treated with catheter ablation.[3,4]
Two-thirds of AF ablation cases were completed within the first session
Summary
Atrial fibrillation (AF) is the most prevalent form of arrhythmia with an increasing incident worldwide; it is associated with an increased lifetime risk of stroke, heart failure, myocardial infarction, dementia, and mortality.[1,2] Whether AF presents or not is crucial for making a clinical decision regarding treatment strategy. Long-term monitoring devices have revealed under-detection of AF via Holter ECG,[5,6] they have shortcomings. AF patients are still in need of a medical-grade device for long-term non-invasive and continuous ECG monitoring. A wearable ECG with a medicalgrade dry textile electrode is a promising technology to remedy this limitation. This pilot study aimed to simultaneously compare the wearable and Holter ECGs for ambulatory monitoring in a clinical setting. Results: Simultaneous ECG monitoring demonstrated a comparable analysis time and total heart beats between the two devices. The results of this study warrant further clinical studies for long-term monitoring of ambulatory ECG after AF ablation
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