scholarly journals Applicability of a Novel Wearable Wireless Electrocardiogram Monitoring Device (Spyder) for Arrhythmia Detection in Patients with Suspected Cardiac Arrhythmias

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Do Van Chien ◽  
Nguyen Thanh Binh ◽  
Nguyen Dung ◽  
Pham Truong Son
Keyword(s):  
Atrial Fibrillation ◽  
Supraventricular Tachycardia ◽  
Cardiac Arrhythmias ◽  
Cryptogenic Stroke ◽  
Premature Ventricular Contraction ◽  
Monitoring Device ◽  
Ecg Monitoring ◽  
Monitoring Methods ◽  
New Device ◽  
Recurrent Atrial Fibrillation

Introduction. In clinical practice, many cardiovascular symptoms can be caused by arrhythmias that are not detected by electrocardiography (ECG) or 24–48 h Holter ECG monitoring. Aims. To describe the efficacy and applicability of a new device (Spyder) in detecting cardiac arrhythmias with midterm ECG monitoring. Methods. A descriptive, prospective study was performed on 26 consecutive patients who underwent midterm ECG monitoring with the novel ECG patch device (Spyder). The study was conducted over a 6-month period from August 2020 to February 2021. Results. Twenty-six patients (mean age, 57.8 ± 12.5 years; men, 77%) wearing a Spyder wireless ECG-monitoring device were recruited. The mean wearing time was 84 hours. The main indications for using the device were detection of recurrent atrial fibrillation after radiofrequency ablation (30.7%) and screening for atrial fibrillation after cryptogenic stroke (23.1%). All ECG monitor recordings obtained during the study period were of good quality. The device detected 12 episodes of atrial fibrillation in eight patients, one episode of ventricular tachycardia, one supraventricular tachycardia event, one case of paroxysmal third-degree atrioventricular block, and five cases of frequent premature ventricular contraction. The time to detection of the first episodes of atrial fibrillation and ventricular and supraventricular tachycardia was 28.8 and 47 hours, respectively. Conclusions. The new wearable wireless ECG-monitoring device (Spyder) is a feasible and effective method for the detection of cardiac arrhythmias.

scholarly journals Potential Biological Markers of Atrial Fibrillation: A Chance to Prevent Cryptogenic Stroke

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
István Szegedi ◽  
László Szapáry ◽  
Péter Csécsei ◽  
Zoltán Csanádi ◽  
László Csiba
Keyword(s):  
Atrial Fibrillation ◽  
Biological Markers ◽  
Cryptogenic Stroke ◽  
Biological Marker ◽  
Ecg Monitoring ◽  
Inflammation Markers ◽  
Good Patient ◽  
Markers Of Inflammation ◽  
Good Patient Compliance ◽  
And Function

Stroke affects millions of people all over the world, causing death and disability. The most frequent type of this disease is ischemic stroke, which can be caused by different factors. In approximately 25 percent of cases, no obvious cause can be found. Recent observations have shown that paroxysmal atrial fibrillation could be responsible for a significant number of cryptogenic stroke events. Short- or long-lasting ECG monitoring could help with the diagnosis of transient arrhythmias. Unfortunately, these techniques either are expensive or require good patient compliance. An alternative option is the identification of biological markers that are specific for atrial fibrillation and can be used to predict arrhythmia. In this review, we give a summary of the recent advances in the research of arrhythmia markers. Based on their structure and function, we differentiated four groups of biomarkers: markers of inflammation, markers of fibrosis, markers with hormonal activity, and other markers. In spite of intensive researches, the optimal biological marker is still not available, but there are some promising markers, like NT-proBNP/BNP.

scholarly journals Infarct Topography and Detection of Atrial Fibrillation in Cryptogenic Stroke: Results from CRYSTAL AF

2015 ◽  
Vol 40 (1-2) ◽  
pp. 91-96 ◽  
Author(s):  
Richard A. Bernstein ◽  
Vincenzo Di Lazzaro ◽  
Marilyn M. Rymer ◽  
Rod S. Passman ◽  
Johannes Brachmann ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cox Regression ◽  
Brain Infarction ◽  
Cryptogenic Stroke ◽  
Monitoring Methods ◽  
Brain Images ◽  
Kaplan Meier ◽  
Imaging Characteristics ◽  
Hazard Ratios ◽  
Routine Monitoring

Background: Insertable cardiac monitors (ICM) have been shown to detect atrial fibrillation (AF) at a higher rate than routine monitoring methods in patients with cryptogenic stroke (CS). However, it is unknown whether there are topographic patterns of brain infarction in patients with CS that are particularly associated with underlying AF. If such patterns exist, these could be used to help decide whether or not CS patients would benefit from long-term monitoring with an ICM. Methods: In this retrospective analysis, a neuro-radiologist blinded to clinical details reviewed brain images from 212 patients with CS who were enrolled in the ICM arm of the CRYptogenic STroke And underLying AF (CRYSTAL AF) trial. Kaplan-Meier estimates were used to describe rates of AF detection at 12 months in patients with and without pre-specified imaging characteristics. Hazard ratios (HRs), 95% confidence intervals (CIs), and p values were calculated using Cox regression. Results: We did not find any pattern of acute brain infarction that was significantly associated with AF detection after CS. However, the presence of chronic brain infarctions (15.8 vs. 7.0%, HR 2.84, 95% CI 1.13-7.15, p = 0.02) or leukoaraiosis (18.2 vs. 7.9%, HR 2.94, 95% CI 1.28-6.71, p < 0.01) was associated with AF detection. There was a borderline significant association of AF detection with the presence of chronic territorial (defined as within the territory of a first or second degree branch of the circle of Willis) infarcts (20.9 vs. 10.0%, HR 2.37, 95% CI 0.98-5.72, p = 0.05). Conclusions: We found no evidence for an association between brain infarction pattern and AF detection using an ICM in patients with CS, although patients with coexisting chronic, as well as acute, brain infarcts had a higher rate of AF detection. Acute brain infarction topography does not reliably predict or exclude detection of underlying AF in patients with CS and should not be used to select patients for ICM after cryptogenic stroke.

scholarly journals Non-invasive mid-term ECG monitoring for the detection of atrial fibrillation in an outpatient population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Cai ◽  
K.K Yeo ◽  
P Wong ◽  
C.K Ching
Keyword(s):  
Atrial Fibrillation ◽  
Public Institution ◽  
First Episode ◽  
Prior History ◽  
Funding Source ◽  
Monitoring Device ◽  
Ecg Monitoring ◽  
Non Invasive ◽  
Increased Risk ◽  
The Mean

Abstract Background Atrial fibrillation (AF) is a common arrhythmia with significant morbidity due to an increased risk of ischemic stroke. Outpatient electrocardiogram (ECG) monitoring is an integral part of the diagnosis of AF. Conventional 24 hour Holter monitoring can be cumbersome and often fails to diagnose patients with paroxysmal AF. Spyder ECG is a non-invasive ECG monitoring device that allows wireless transmission of ECG information for analysis. It is small and comfortable, allowing for easy application for the screening and detection of AF over a mid-term duration. Purpose This study aims to evaluate the incidence of AF in patients with no prior AF and CHADsVASC score of at least 1 with the use of the Spyder ECG mid-term ECG monitoring device. Methods Patients aged 21 to 85 years old with no prior history of AF and CHADsVASC score of at least 1 were recruited from outpatient clinics of 3 large tertiary hospitals in Singapore from December 2016 to April 2019. Patients wore the Spyder ECG device for up to 2 weeks, during which continuous ECG information was uploaded onto a central cloud database and analysed. Results There were 363 patients recruited. The mean age was 61±10.0 years and 65.1% were male. There were 80.3% Chinese, 11.6% Malay, 7.5% Indian and 20.6% of other races. 68.3% of the patients were non-smokers and 74.0% of them were non-alcohol drinkers. The mean BMI of 25.5±4.7 kg/m2. The patient population had significant co-morbidities. 76.3% of the patients had hypertension, 69.4% of them had hyperlipidemia and 40.5% of them had diabetes mellitus. 10.0% of them had congestive cardiac failure and 56.7% had ischaemic heart disease. 11.3% of patients had a previous stroke and 20.4% had a prior myocardial infarction. 7.8% of the patients had asthma, 5.8% of them had thyroid disease and 9.9% of them had chronic kidney disease. They were monitored for a mean of 5.4±2.9 days each. There were 15 (4.1%) patients in whom AF was detected. The patients with AF wore the device for a mean of 5.7±2.0 SD days. The mean burden of AF was 9.0% of monitored time. 46.7% of the patients with AF had detection of AF on the first day, 26.7% on the second day, 13.3% on the third day and 13.3% on the seventh day. The mean duration of the first episode of AF was 251±325 minutes. 7 out of 15 (46.7%) of patients had first episodes of AF lasting less than 10 minutes. Conclusion Continuous mid-term ECG monitoring was able to detect AF in 15 (4.1%) of a population of 363 patients with no prior AF and CHADsVASC score of at least one, monitored for a mean of 5.4 days. Most episodes (53.3%) of AF were detected after the first day of ECG monitoring. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Duke-NUS Medical School Singapore

scholarly journals Holter Monitoring and Loop Recorders: From Research to Clinical Practice

2016 ◽  
Vol 5 (2) ◽  
pp. 136 ◽  
Author(s):  
Alessio Galli ◽  
Francesco Ambrosini ◽  
Federico Lombardi ◽  
◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Arrhythmias ◽  
Cardiac Rhythm ◽  
Cryptogenic Stroke ◽  
Heart Rhythm ◽  
Holter Monitoring ◽  
Cardioverter Defibrillator ◽  
Proven Efficacy ◽  
Prolonged Monitoring ◽  
Monitoring Technologies

Holter monitors are tools of proven efficacy in diagnosing and monitoring cardiac arrhythmias. Despite the fact their use is widely prescribed by general practitioners, little is known about their evolving role in the management of patients with cryptogenic stroke, paroxysmal atrial fibrillation, unexplained recurrent syncope and risk stratification in implantable cardioverter defibrillator or pacemaker candidates. New Holter monitoring technologies and loop recorders allow prolonged monitoring of heart rhythm for periods from a few days to several months, making it possible to detect infrequent arrhythmias in patients of all ages. This review discusses the advances in this area of arrhythmology and how Holter monitors have improved the clinical management of patients with suspected cardiac rhythm diseases.

Atrial Fibrillation and Other Cardiac Arrhythmias (DRAFT)

2018 ◽  
Author(s):  
Antoine Schneider ◽  
Rinaldo Bellomo
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Cardiac Arrhythmias ◽  
Older Patients ◽  
Hospital Setting ◽  
Rapid Response Team ◽  
Hospitalized Patients ◽  
Response Team

Cardiac arrhythmias are common in hospitalized patients, with their incidence increasing in older patients and those with comorbidities. Cardiac arrhythmias represent a trigger for approximately 10% of rapid response team (RRT) activations. Of those, atrial fibrillation (AF) is the most commonly observed. Other common cardiac arrhythmias in the in-hospital setting include supraventricular tachycardia, atrial flutter, ventricular tachycardia, and bradycardias. Members of the RRT should be skilled in the diagnosis and management of these common arrhythmias. This chapter presents an overview of cardiac arrhythmias that RRT members are likely to encounter, discussing their incidence and significance, as well as their immediate management.

P3859Long-term noninvasive ecg monitoring in atrial fibrillation detection in patients after cryptogenic stroke

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
V Bulkova ◽  
P Jansky ◽  
D Kovarikova ◽  
H Alfredova ◽  
V Dlugosova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cryptogenic Stroke ◽  
Ecg Monitoring ◽  
Atrial Fibrillation Detection

Abstract 14972: Sub-clinical Atrial Fibrillation in Elderly Primary Care Patients Without Clinical Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jeff S Healey ◽  
Stuart J Connolly ◽  
Veena Manja ◽  
Yan Liu ◽  
Kim D Simek ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Primary Care ◽  
Coronary Disease ◽  
Cryptogenic Stroke ◽  
Left Ventricular ◽  
Ecg Monitoring ◽  
High Background ◽  
Non Invasive ◽  
History Of

Introduction: Sub-clinical AF has been reported in 10% of pacemaker patients (≥ 6 minutes, with 3 months of monitoring) and 16% of patients following cryptogenic stroke (≥ 30 seconds, with 1 month of monitoring). It is unknown how common sub-clinical AF is among other patient groups, including the elderly. These data are needed to give context to the detection of sub-clinical AF in clinical practice. Methods: We prospectively investigated the prevalence of sub-clinical AF among individuals ≥ 80 years, without known AF or symptoms of arrhythmia, attending primary care clinics. Subjects had a history of hypertension and at least one of the following: diabetes, BMI ≥ 30, sleep apnea, smoking, coronary disease, heart failure or left ventricular hypertrophy. Patients were recruited from 7 Ontario family practice clinics (n=119) and one general medicine clinic (n=10). Patients underwent 30 days of continuous, non-invasive ambulatory ECG monitoring using a device with automatic AF detection (Vitaphone 3100). The primary outcome was a composite of atrial flutter (AFL) or AF ≥ 6 minutes in duration. Those without AF were invited to complete an additional 30 days of monitoring. Results: Of 129 patients screened and consented, 100 patients initiated monitoring for an average monitoring duration of 36± 21 days. The mean (SD) age was 84 ± 3 years and systolic blood pressure was 138 ± 17 mmHg; 50% had coronary disease, 28% had diabetes and 6% had heart failure. Only 4% had a history of prior stroke. Thirty days of monitoring was completed by 57% of patients and 31% completed an additional 30 days. AFL or AF ≥ 30 seconds duration was documented in 19/100 patients; ≥ 6 minutes in 15; ≥ 30 minutes in 12; ≥ 6 hours in 8 and ≥ 24 hours in 2. Shorter episodes of atrial tachycardia lasting less than 30 seconds were observed in 47 patients. Conclusions: In this prospective, outpatient study, using non-invasive ECG monitoring, we found AFL or AF ≥ 6 minutes in 15% of elderly individuals with stroke risk factors. This high background prevalence of AFL/AF among elderly patients suggests a possible role for AF screening in this population; but also should be taken into consideration when interpreting the prevalence of AFL/AF in other populations.

Early Detection of Symptomatic Paroxysmal Cardiac Arrhythmias by Trans-Telephonic ECG Monitoring: Impact on Diagnosis and Treatment of Atrial Fibrillation

2016 ◽  
Vol 27 (9) ◽  
pp. 1032-1037 ◽  
Author(s):  
JOHANNA ANCZYKOWSKI ◽  
STEPHAN WILLEMS ◽  
BORIS A. HOFFMANN ◽  
THOMAS MEINERTZ ◽  
STEFAN BLANKENBERG ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Early Detection ◽  
Cardiac Arrhythmias ◽  
Diagnosis And Treatment ◽  
Ecg Monitoring

scholarly journals Cost-Effectiveness of Extended Electrocardiogram Monitoring for Atrial Fibrillation After Stroke

Stroke ◽  
2020 ◽  
Vol 51 (7) ◽  
pp. 2244-2248 ◽  
Author(s):  
Derek S. Chew ◽  
Elissa Rennert-May ◽  
Eldon Spackman ◽  
Daniel B. Mark ◽  
Derek V. Exner
Keyword(s):  
Atrial Fibrillation ◽  
Cost Effectiveness ◽  
Standard Care ◽  
Cryptogenic Stroke ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Ecg Monitoring ◽  
The Cost ◽  
Monitoring Devices ◽  
Rhythm Monitoring

Background and Purpose: Management of cryptogenic stroke involves the identification of modifiable risk factors, such as atrial fibrillation (AF). Extended rhythm monitoring increases AF detection rates but at an increased device cost compared with conventional Holter monitoring. The objective of the study was to identify and synthesize the existing literature on the cost-effectiveness of prolonged rhythm monitoring devices for AF detection in cryptogenic stroke. Methods: We conducted a systematic review of available economic evaluations of prolonged ECG monitoring for AF detection following cryptogenic stroke compared with standard care. Results: Of the 530 unique citations, 8 studies assessed the cost-utility of prolonged ECG monitoring compared with standard care following cryptogenic stroke. The prolonged ECG monitoring strategies included 7-day ambulatory monitoring, 30-day external loop recorders or intermittent ECG monitoring, and implantable loop recorders. The majority of cost-utility analyses reported incremental cost-effectiveness ratios below $50 000 per QALY gained; and two studies reported a cost-savings. Conclusions: There is limited economic literature on the cost-effectiveness of extended ECG monitoring devices for detection of atrial fibrillation in cryptogenic stroke. In patients with cryptogenic stroke, extended ECG monitoring for AF detection may be economically attractive when traditional willingness-to-pay thresholds are adopted. However, there was substantial variation in the reported ICERs. The direct comparison of cost-effectiveness across technologies is limited by heterogeneity in modeling assumptions.

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