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ZIO XT Patch- Making The Holter Monitor Obsolete?

Started By: RDGlatter, MD, Emergency Medicine, 1:51PM Jul 02, 2014

As wearable technology utilizing wristbands and head bands continues to emerge, allowing people to monitor their heart rate during exercise and while walking, a new device called the ZIO XT patch may offer patients who are seen and treated not only in outpatient settings, but discharged from the emergency department the opportunity for rapid and reliable monitoring for cardiac dysrhythmias.

The ZIO XT Patch is a continuous-recording ECG monitor (single channel), that may be worn up to 2 weeks by patients being evaluated for possible cardiac dysrhythmias.  It requires a prescription for use at this time.  The company states that it may be used for patients who may be asymptomatic or “who may suffer from transient symptoms such as palpitations, shortness of breach, dizziness, lightheadedness, presyncope, syncope, fatigue, or anxiety.” According to the company, there are no contraindications to the use of the patch.

The ZIO XT Patch (5 inches x 2 inches;24.5 grams; central button) is affixed to the upper aspect of the left chest via an adhesive and fits under standard clothing. The patch is waterproof and may be worn 24 hours a day. The patch provides continuous monitoring of the  the cardiac rhythm. If the patient becomes symptomatic, a central button can be pushed to highlight the recording. After the 2 week period, the patient removes the patch and places it in a pre-packaged box to be mailed to a testing facility in California or Illinois to undergo rhythm and data collection analysis.  Initial cost estimates are about $200.00.

Results thus far using the patch are quite promising, and suggest that the device may be a reasonable alternative to Holter or event monitors for the outpatient evaluation of patients with possible cardiac arrhythmias. In once recent study (http://www.ncbi.nlm.nih.gov/pubmed/24672611) using the patch, researchers studied 174 patients who had presented to the ED with palpitations, with concern for possible dysrhythmia.  Upon discharge form the ED, the ZIO XT Patch was applied and worn for up to 2 weeks or until the patient developed symptoms. Results indicated that dysrhythmias were noted in 63 percent of patients. 48 percent of patients experienced at least one significant event:  ventricular tachycardia, paroxysmal atrial fibrillation, supraventricular tachycardia, >3 second pause, Mobitz II, third-degree AV block, or symptomatic bradycardia.

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