Patch Monitors for Arrhythmia Monitoring in Patients for Suspected Inherited Arrhythmia Syndrome.

Cheung, Christopher C; Davies, Brianna; Gibbs, Karen; Laksman, Zachary W; Krahn, Andrew D

INTRODUCTION Patients undergoing evaluation for an inherited arrhythmia syndrome undertake a series of ambulatory investigations including 24-hour Holter monitor, exercise treadmill testing (ETT), and others. Patch monitors may simplify the evaluation, providing accurate arrhythmia evaluation and QT assessment. METHODS AND RESULTS Patients referred for evaluation of an inherited arrhythmia syndrome underwent standard investigations, including 12-lead ECG, 24-hour Holter monitoring, ETT, along with supplemental monitoring using a 7-day ECG patch monitor. Heart rates (HR), corrected QT intervals (QTc), and ectopic burden were compared across monitoring modalities. Among 35 patients that wore the patch monitor, the median age was 39 years (54% male). There was intermediate correlation between resting HR across modalities (r=0.58-0.66) and poor correlation of peak HR (r=0.27-0.39). There was intermediate correlation between resting QTc intervals across modalities (r=0.72-0.77) but negligible correlation between QTc intervals at peak HR across modalities (r=-0.01 to -0.06). There was good correlation in PAC and PVC ectopic burden across the Holter and patch monitor. CONCLUSION Patch monitors may simplify the evaluation of patients for an inherited arrhythmia syndrome and provide resting QT assessment over time. However, QTc interval comparison at peak heart rates remains variable, and may be limited by the single-lead ECG vector when using the patch monitor. Apart from QTc intervals at peak HR, patch monitors demonstrated good correlation with the ECG and Holter monitor for other parameters. This article is protected by copyright. All rights reserved.