RT Journal Article
SR Electronic
T1 Is 7-day event triggered ECG recording equivalent to 7-day Holter ECG recording for atrial fibrillation screening?
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 645
OP 649
DO 10.1136/heartjnl-2011-301455
VO 98
IS 8
A1 Laurent Roten
A1 Manuel Schilling
A1 Andreas Häberlin
A1 Jens Seiler
A1 Nicola G Schwick
A1 Jürg Fuhrer
A1 Etienne Delacrétaz
A1 Hildegard Tanner
YR 2012
UL http://heart.bmj.com/content/98/8/645.abstract
AB Objective Prolonged ECG monitoring is standard for atrial fibrillation (AF) screening. This study investigated whether 7-day event triggered (tECG) ECG recording is equivalent to 7-day continuous Holter (cECG) ECG recording for AF screening.Design Both a cECG (Lifecard CF) and a tECG (R.Test Evolution 3) were simultaneously worn for 7 days by patients with known or suspected paroxysmal AF.Results In 100 corresponding recordings, median effective duration of monitoring was 165 h (range 10–170 h) for cECG and 137 h (0–169 h) for tECG (p<0.001). Median number and total duration of arrhythmias (AF, atrial flutter or atrial tachycardia) of ≥30 s duration recorded by cECG were 10 (1–428) and 1030 min (≤1–10 020), respectively. An arrhythmia was recorded in 42 cECGs (42%) versus 37 tECGs (37%, p=0.56). Triggered ECG failed to record an arrhythmia in cECG positive cases because of interrupted monitoring in four cases and because of recording failure in one case. Sensitivity, specificity, and positive and negative predictive values of tECG therefore were 88%, 100%, 100%, and 92%, respectively. Quantitative cECG analysis required a median of 20 min (3–205 min) and qualitative tECG analysis 4 min (1–20 min; p<0.001). Skin irritation was a frequent side effect (42%) resulting in premature removal of devices in 16% of patients.Conclusion Sensitivity of tECG for AF screening as compared to cECG is lower, mainly because of shorter effective monitoring duration. Qualitative tECG analysis is less time consuming than quantitative cECG analysis. Skin irritation is a frequent side effect and reason for premature device removal.