Enhanced detection of cardiac arrhythmias utilizing 14-day continuous ECG patch monitoring

Chih Min Liu, Shih Lin Chang*, Yung Hsin Yeh, Fa Po Chung, Yu Feng Hu, Chung Chuan Chou, Kuo Chun Hung, Po Cheng Chang, Jo Nan Liao, Yi Hsin Chan, Li Wei Lo, Lung Sheng Wu, Yenn Jiang Lin, Ming Shien Wen, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: To evaluate the performance of a single‑lead, 14-day continuous electrocardiogram (ECG) patch for the detection of arrhythmias compared to conventional 24-h monitoring. Methods: This prospective clinical trial enrolled patients suspected of arrhythmias but not diagnosed by 12‑lead ECGs. Each patient underwent a 24-h Holter and 14-day ECG patch simultaneously. Seven types of arrhythmias were classified: supraventricular tachycardia (SVT, repetitive atrial beats >4 beats), irregular SVT without P wave (>4 beats), AF/AFL (irregular SVT without P wave ≥30 s), pause ≥3 s, atrioventricular block (AVB; Mobitz type II, third-degree, two to one or high degree AVB), ventricular tachycardia (VT), and polymorphic VT. Results: A total of 158 patients were recruited (mean wear time:12.3 ± 3.2 days). The overall arrhythmia detection rate was higher with 14-day ECG patches (59.5%) compared to 24-h Holter (19.0%, P < 0.001). Up to 87.2% of arrhythmias recorded with 14-day ECG patches were not associated with symptoms. The 14-day ECG patch was associated with higher detection rates compared to the 24-h Holter in patients with SVT (52.5% versus 15.8%, P < 0.001), irregular SVT without P wave (12.7% versus 4.4%, P = 0.002), AF/AFL (9.5% versus 3.8%, P = 0.042), and critical arrhythmias (pause ≥3 s, AVB, VT, polymorphic VT) (16.5% versus 2.5%, P < 0.001). The 14-day ECG patch detected more than 2 types of arrhythmias in 5.1% of patients. No serious adverse events in patients wearing the 14-day ECG patch were reported. Conclusions: The 14-day ECG patch outperformed 24-h Holter to detect overall, asymptomatic, critical and multiple arrhythmias. It is safe and has the potential to identify individuals with hidden arrhythmias, especially those with critical arrhythmias.

Original languageEnglish
Pages (from-to)78-84
Number of pages7
JournalInternational Journal of Cardiology
StatePublished - 1 Jun 2021


  • 14-day electrocardiogram monitor
  • 24-h Holter
  • Arrhythmia
  • Electrocardiography
  • Medical device


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