Abstract

Aims

To compare the diagnostic yield, or ability to detect arrhythmias - especially paroxysmal atrial fibrillation (PAF) - of the conventional Ambulatory Holter monitoring device with the Wellysis S Patch, a novel, dual-lead, low-profile device.

Methods

Patients referred for ambulatory electrocardiographic (ECG) monitoring wore both devices simultaneously for 24-48 hours and the incidence of clinically significant arrhythmias were compared. Patients who satisfied the eligibility criteria as well as referred for ambulatory ECG monitoring were consented and enrolled prospectively to have the Holter monitor and the Wellysis S Patch device placed simultaneously. A patient satisfaction survey was given to the patient and parent/guardian after completion of the study to compare the comfort, interference with daily activities, adverse events (such as skin irritation or if either device fell off), and preference for each device. The overall performance (comfort of wearing, ease of use, efficiency and durability, clarity of recorded signals) 

Results

When it comes to comfort of wearing, ease of use, efficiency and durability, clarity of recorded signals of Wellysis S Patch was found to be superior to conventional Holter (feedback from patients, paramedical staff, clinical staff regarding the comfort of wearing, usability, operational efficiency) by Mc Nemars analysis, which revealed odds ratio of 8.75 with a 95% CI 4.205 to 21.060, P < 0.0001. 

Conclusion 

Multi lead ambulatory Holter monitoring remains the gold standard for arrhythmia detection in stroke patients. However Wellysis S Patch device has a definite complementary role in the detection of paroxysmal atrial fibrillation (PAF) in stroke patients. However with advances in technology a paradigm shift is possible.