Authors (including presenting author) :
Chan LS(1), Wong CW(1), Yam PW(2), Wong SY(1), Chan TH(1), Fong MC(1), Mak WL(1)
Affiliation :
(1)Department of Medicine and Geriatrics, Pok Oi Hospital, (2)Department of Medicine and Geriatrics, Tuen Mun Hospital
Introduction :
Traditional Holter ECG is often considered the gold standard for assessment of arrhythmia but its use is limited by labour intensity and inconvenience. With the growing population, the demand is getting higher. We introduced three commercially available patch ECG devices in NTWC in order to lessen the burden on our healthcare system. The ECG data were uploaded to the respective vendors after completion and were analyzed by their technicians or doctors.
Objectives :
To evaluate the accuracy and effectiveness of this approach
Methodology :
Total 467 cases were completed from January to June of 2023 in Tuen Mun Hospital, Pok Oi Hospital and Tin Shui Wai Hospital. The baseline demographics, indication for ambulatory ECG monitoring and outcomes were analyzed. Preliminary reports from vendors were reviewed by our Cardiologist to assess the level of agreement. Tracing was reviewed by expert electrophysiologist if there were any disagreement. All reports were delivered within 24 hours after uploading.
Result & Outcome :
Only 1 out of 467 cases needed to be repeated. Main baseline characteristics included the following: mean age was 59 years-old, 47% were male, hypertension and diabetes were the commonest comorbidity, mean CHADSVAS score for patient with pre-existing AF is 2.76. Palpitation and syncope are the most common and 2nd commonest indication respectively. Around 24% of the cases recorded clinically relevant arrhythmia. Supraventricular tachycardia is the most common abnormal finding among these. Another frequent finding is bradycardia. Rare findings include AV block and new diagnose of atrial fibrillation. One patient died during the monitoring period and ECG tracing caught Torsade de pointe. We define noise as duration of tracing that is not analyzable. It is only found in a small proportion of studies and among these studies, on average 6.8% of recording time are regarded as noise. There was high agreement with only few exceptions between preliminary and our review. One case of long conversion sinus pauses following atrial filtration was misinterpreted as artifacts, while other misinterpretations did not affect subsequent management.
Conclusions: The patch ambulatory ECG devices provided another effective mean of portable ECG monitoring. Overall, it provided good accuracy in terms of excluding clinically significant arrhythmias.
