Continuous ECG monitoring versus mobile telemetry: A comparison of arrhythmia diagnostics in human- versus algorithmic-dependent systems.
Heart Rhythm O2
; 2(6Part A): 543-559, 2021 Dec.
Article
em En
| MEDLINE
| ID: mdl-34988499
ABSTRACT
BACKGROUND:
Clinicians rarely scrutinize the full disclosure of a myriad of FDA-approved long-term rhythm monitors, and they rely on manufacturers to detect and report relevant rhythm abnormalities.OBJECTIVE:
The objective of this study is to compare the diagnostic accuracy between mobile cardiac telemetry (MCT), which uses an algorithm-based detection strategy, and continuous long-term electrocardiography (LT-ECG) monitoring, which uses a human-based detection strategy.METHODS:
In an outpatient arrhythmia clinic, we enrolled 50 sequential patients ordered to wear a 30-day MCT, to simultaneously wear a continuous LT-ECG monitor. Periods of concomitant wear of both devices were examined using the associated report, which was over-read by 2 electrophysiologists.RESULTS:
Forty-six of 50 patients wore both monitors simultaneously for an average of 10.3 ± 4.4 days (range 1.2-14.8 days). During simultaneous recording, patients were more often diagnosed with arrhythmia by LT-ECG compared to MCT (23/46 vs 11/46), P = .018. Similarly, more arrhythmia episodes were detected during simultaneous recording with the LT-ECG compared to MCT (61 vs 19), P < .001. This trend remained consistent across arrhythmia subtypes, including ventricular tachycardia (13 patients by LT-ECG vs 7 by MCT), atrioventricular (AV) block (3 patients by LT-ECG vs 0 by MCT), and AV node reentrant tachycardia (2 patients by LT-ECG vs 0 by MCT). Atrial fibrillation (AF) was documented by both monitors in 2 patients; however, LT-ECG monitoring captured 4 additional AF episodes missed by MCT.CONCLUSION:
In a time-controlled, paired analysis of 2 disparate rhythm monitors worn simultaneously, human-dependent LT-ECG arrhythmia detection significantly outperformed algorithm-based MCT arrhythmia detection.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Diagnostic_studies
Idioma:
En
Revista:
Heart Rhythm O2
Ano de publicação:
2021
Tipo de documento:
Article