Prospective comparison of the diagnostic utility of a standard event monitor versus a “leadless” portable ECG monitor in the evaluation of patients with palpitations

Daniel Scherr, Darshan Dalal, Charles A. Henrikson, David D. Spragg, Ronald D. Berger, Hugh Calkins and Alan Cheng

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Abstract

Introduction  

Current ambulatory ECG monitoring systems are limited in their ability to diagnose patients with palpitations. The aim of this prospective study was to compare a new “leadless” ambulatory monitor with a standard event monitor in the evaluation of patients with palpitations.

Methods  

Eighteen consecutive patients (11 female, 56 ± 16 years) referred for evaluation of palpitations were provided with both a standard event monitor and a “leadless” monitor for 30 days. They were asked to record episodes of palpitations with both monitoring devices.

Results  

All 18 individuals were compliant with the “leadless” monitor for the 30-day period while only 14 (78%) patients were compliant with the standard event monitor (p = 0.10). During a combined monitoring period of 563 days, 159 symptomatic episodes were recorded with the “leadless” ECG monitor (8.8 ± 9.7 per patient, range 1–35) and 169 symptomatic episodes were recorded with the event monitor (12 ± 8.3 per patient, range 1–33) (p = NS). The “leadless” ECG monitor recorded arrhythmias in 13 of 18 patients (72%) and the standard event monitor recorded arrhythmias in 8 of 14 patients (57%) (p = NS).

Conclusion  

The “leadless” ECG monitor is associated with high patient compliance and results in high quality ECG recordings. The diagnostic yield of this monitoring system is equivalent to a standard event monitor.

Keywords  Palpitations - ECG - Ambulatory Monitor - Arrhythmias

Dr. Daniel Scherr was supported by a research grant of the FWF Austrian Science Fund.

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