Three-day monitoring of adhesive single-lead electrocardiogram patch for premature ventricular complex: validation of diagnostic yield and evaluation of burden fluctuation (Preprint)

Abstract

Wearable monitoring devices of an electrocardiogram (ECG) are widely used. However, the date of an adhesive single-lead ECG patch (SEP) in the diagnosis and 24-hour burden assessment of premature ventricular complex (PVC) is limited.

We validated the diagnostic yield of SEP (mobiCARE™ MC-100, Seers Technology) for PVC detection and evaluated the variation of PVC burden monitored during three days.

Patients with documented PVC on a 12-lead ECG were recruited. They underwent simultaneous ECG monitoring by the Holter and SEP on the first day. On the subsequent second and third days, ECG monitoring by SEP was continued and completed 3-day extended monitoring. We compared the detection yield of PVC on the first day of SEP to that of the Holter. Daily and 6-hour PVC burden variation was evaluated from the SEP data. The number of patients additionally identified to reach PVC thresholds of 10%, 15%, and 20% on 3-day extended monitoring of SEP and clinical factors associated with the higher burden variation were explored.

Recruited data of 134 monitored patients (mean age, 54.6 years; male, 33.6%) were analyzed. The median daily PVC burden was 2.4 (0.2-10.9) % by the Holter and 3.3 (0.3-11.7) % for the 3-day monitoring of SEP. The daily PVC burden detected on the first day of SEP was in agreement with that of the Holter: the mean difference was -0.07%, with 95% limits of agreement (-1.44%, 1.30%). A higher PVC burden on the first day was correlated with a higher daily (R2=0.34) and 6-hour burden variation (R2=0.48). Three-day monitoring by SEP identified 12/42 (28.6%), 10/56 (17.9%), and 4/60 (6.7%) more patients reaching 10%, 15%, and 20% of daily PVC burden, respectively. Younger age was associated with an additional detection of PVC burden with clinical significance on the extended monitoring (P=.02).

A SEP accurately detects PVC with a comparable diagnostic yield to the Holter. Three-day monitoring of PVC using SEP could be a practical alternative to identify more patients who cross the significant burden threshold. Young patients might require extended monitoring to determine the optimal treatment strategy for PVC.