CardioSource WorldNews September 2015 | Page 35

analyzed via proprietary algorithms, and the clinician is sent a focused report. “The adhesives are very comfortable to wear so the device can be worn for 14 days,” said Judy Lenane, RN, MHA, executive vice president and chief clinical officer for iRhythm in an interview with CSWN. “They can shower, exercise, live their life, and have the data collected.” In a study of 146 patients who underwent simultaneous ambulatory electrocardiogram (ECG) recording with a 24-hour Holter monitor and a 14-day adhesive patch monitor, the patch monitor ZIO Patch detected 96 arrhythmia events compared with 61 events detected by the Holter (p < 0.001). Not surprisingly, patients found the patch more comfortable to wear.12 “On the basis of these findings, novel, single-lead, prolonged-duration, low-profile devices may soon replace conventional Holter monitoring platforms for the detection of arrhythmia events in patients referred for ambulatory ECG monitoring,” said the Scripps Translation Science Institute researchers, led by Eric J. Topol, MD. Referring to a recent study of the iRhythm device, Sunil Kumar Agarwal, MD, PhD, stressed: “The interesting part is that… about 50% of the people we identified with atrial fibrillation had paroxysmal AF, meaning we will not capture them on a 10-second ECG. Five out of seven patients who had paroxysmal AF were not on anticoagulation.” Dr. Agarwal is a fellow in cardiology at Mt. Sinai School of Medicine, New York. (Scan the QR to see our interview with Dr. Agarwal.) According to the company’s website, more than 300,000 patients have used the patch at more than 800 US institutions and it is widely reimbursed. Does it really matter? After all, a just-published population-based cohort study in Lancet Neurology questioned the presumed importance of paroxysmal AF as the major cause of cryptogenic stroke.13 However, in an accompanying editorial, Jose M. Ferro, MD, from the University of Lisbon, Portugal, questioned the authors’ conclusion because the main study did not use the new devices that allow for prolonged heart rhythm monitoring. In other words, if you don’t look carefully for AF, you may not find it, but that The Diagnostic Odyssey of doesn’t mean it wasn’t Patients with Undetected AF: Advance in Ambulatory there.14 Monitoring With their purchase CSWN Interviews: Sunil Kumar of Corventis, Medtronic Agarwal MD, PHD, Fellow in also has a mobile cardiac Cardiology at the Mt. Sinai School of Medicine and Judy telemetry system that Lenane, Executive Viceuses a peel and stick president and Chief Clinical patch. Officer for iRhythm. InfoBionic (Lowell, Massachusetts) is set to commercialize its remote patient monitoring system, the MoMe Kardia, ACC.org/CSWN Google This which is designed to help detect cardiac arrhythmias in