Initial Clinical Experience with New Technology ePatchTM Extended Holter Monitoring

Abstract

Introduction and objectives: Conventional methods of Holter (H) monitoring, data analysis and reporting can be inefficient, leading to high costs and long response times. Traditional H devices can be cumbersome to wear, and uncomfortable testing can reduce patient compliance and satisfaction, impacting diagnostic performance. This new device ePatchTM is a simple application of patch and activation without the need to charge the battery and without connecting cables (Figure 1). Up to 14 days of continuous Electrocardiogram (ECG) recording. It can be worn in the shower and during exercise. Single channel, up to 14 days. Two channels, up to 7 days. Our objective is to evaluate the quality and diagnostic efficacy of ePatchTM in different clinical settings. Methods: Prospective study of patients with ePatchTM placed in our centre requested for the study of undocumented palpitations, syncope or cryptogenic stroke. Clinical variables, diagnostic accuracy and time to diagnostic event are analysed. Results: The first 154 patients were included, of whom (51.3%) were women, with a mean age of 66.6 years (range 18 to 89). The most frequent indication was palpitations (37%) followed by cryptogenic stroke (34.4%), followed by syncope (28.5%). All patients had correct compliance and tolerance and the monitored ECG was of good quality. A conclusive diagnosis: (sustained symptomatic tachyarrhythmia, atrioventricular block with bradyarrhythmia, significant pauses or atrial fibrillation) was obtained in 15 patients (9.7% of the total). 14-, 7-, and 5-day recorders were used. The median event time since ePatchTM logging began was 2.6 days (range 1 to 5 days). Only the duration of H (OR 10.6), and left atrial dilation (OR 5) were significant predictors of arrhythmic event in the multivariate analysis. Conclusion: ePatchTM is a new H device that offers a simple, complete and effective ECG monitoring system. This new technology is safe and has numerous advantages: spending less time on device logistics and handling, preparing patients efficiently, eliminating the need for additional consumables, and constantly replacing the battery. The ECG monitor can be used for up to 14 days. It is designed to address the challenges of traditional H monitoring.