Abstract

Cardiac electrophysiologic derangements often coexist with disorders of the circulatory system. Capturing and diagnosing arrhythmias and conduction system disease may lead to a change in diagnosis, clinical management and patient outcomes. Standard 12-lead electrocardiogram (ECG), Holter monitors and event recorders have served as useful diagnostic tools over the last few decades. However, their shortcomings are only recently being addressed by emerging technologies. With advances in device miniaturization and wireless technologies, and changing consumer expectations, wearable “on-body” ECG patch devices have evolved to meet contemporary needs. These devices are unobtrusive and easy to use, leading to increased device wear time and diagnostic yield. While becoming the standard for detecting arrhythmias and conduction system disorders in the outpatient setting where continuous ECG monitoring in the short to medium term (days to weeks) is indicated, these cardiac devices and related digital mobile health technologies are reshaping the clinician-patient interface with important implications for future healthcare delivery.

Highlights

  • Sustained and intermittent atrial and ventricular arrhythmias, conduction system disease, and abnormally high ectopic burden can be important markers of cardiovascular disease in the appropriate clinical settings

  • Accumulating evidence supports a link between atrial fibrillation (AF) and sudden cardiac death as well as increased mortality and rehospitalization related to congestive heart failure (Mentz et al, 2012; Chen et al, 2013; Reinier et al, 2014)

  • Early detection of, and prompt intervention on, suspect arrhythmias may prevent the subsequent development of worsening functional class and devastating complications including cardiomyopathy, heart failure, stroke and sudden cardiac death

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Summary

Electrocardiographic patch devices and contemporary wireless cardiac monitoring

Specialty section: This article was submitted to Cardiac Electrophysiology, a section of the journal Frontiers in Physiology. Standard 12-lead electrocardiogram (ECG), Holter monitors and event recorders have served as useful diagnostic tools over the last few decades. Their shortcomings are only recently being addressed by emerging technologies. With advances in device miniaturization and wireless technologies, and changing consumer expectations, wearable “on-body” ECG patch devices have evolved to meet contemporary needs. These devices are unobtrusive and easy to use, leading to increased device wear time and diagnostic yield.

Introduction
Trends in Ambulatory ECG and Rhythm Monitoring Systems
ECG Patch Devices
Holter monitor
Clinical Performance and Evidence
Clinical Implications
Findings
Vision of the Future
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