Abstract 20061: Ambulatory Arrhythmia Detection With ZIO® XT Patch in Pediatric Patients
Introduction: Ambulatory electrocardiogram (ECG) monitoring devices are used for 24-72 hours to detect arrhythmias. A novel device, ZIO® XT Patch (ZIO), can be utilized for ECG monitoring for 14 days. The purpose of this study is to describe the duration of ZIO use by age, as well as time to arrhythmia detection in the pediatric population.
Methods: A single-center, retrospective review of patients ≤ 17 yrs of age prescribed a ZIO from 10/14 to 2/16. Demographic and diagnostic data were analyzed, along with duration of ZIO use and time to first arrhythmia. Arrhythmia was defined as supraventricular tachycardia (SVT), advanced atrioventricular block (AV block), or ventricular tachycardia (VT). All ZIO reports were reviewed by a blinded pediatric electrophysiologist. Comparisons were made to 24-hour Holter monitors from the same time period.
Results: A total of 406 ZIO monitors were prescribed for 363 patients; median age 12.7 yrs (0.01-17 yrs), 50% male. The median duration of monitoring significantly increased with age: 1 day (1-14) for 41 ZIO in age < 3 yrs, 2 days (1-13) for 57 ZIO in age 3-6 yrs, 3 days (1-14) for 109 ZIO in age 7-12 yrs, and 4 days (1-14) for 199 ZIO in age 13-17 yrs (p < 0.001). A total of 499 Holter monitors were performed; median age 4.9 yrs (0.03-17 yrs), 51% male. Median age differed between the ZIO and Holter groups (p < 0.0001), but rates of arrhythmia detection were similar: 11% by ZIO vs 10% by Holter (p = 0.51). Arrhythmia was identified on: 45 ZIO (35 SVT, 3 AV block, 7 VT) and 48 Holter (34 SVT, 3 AV block, 11 VT). The first arrhythmia on ZIO occurred in < 24 hrs of monitoring in 42% patients, 24-71 hrs in 24%, and > 72 hrs in 33%, while arrhythmias detected by Holter monitor all occurred within < 24 hrs. A significant number were detected with ZIO after 24 hrs (p < 0.0001). Indications for monitoring in patients with first documented arrhythmia at > 72 hrs were palpitations (11) and previous arrhythmia (4).
Conclusions: The ZIO® XT Patch should be considered to detect arrhythmias in pediatric patients of all ages with palpitations or previous arrhythmia. Duration of ZIO monitoring significantly increased with increasing patient age. The majority of arrhythmias occurred after > 24 hours, with a significant number requiring greater than 3 days of continuous monitoring.
- Pediatric electrophysiology
- Pediatric cardiology
- Supraventricular tachycardia
- Heart block
- Ventricular tachycardia
Author Disclosures: J.A. Robinson: None. K. Tsung: None. E. Lu: None. J.K. Shivapour: None. C.S. Snyder: None.
- © 2016 by American Heart Association, Inc.