Key result
Noninvasive ambulatory ECG monitoring significantly reduced the mean time to physician registration of atrial fibrillation compared to an implantable loop recorder (8 vs 20 hours; p=0.005).
Why the study?
The study was conducted to estimate the efficacy of noninvasive ambulatory ECG monitoring compared with an implantable loop recorder in patients with atrial fibrillation.
Does noninvasive ambulatory ECG monitoring provide comparable diagnostic value to implantable loop recorders in patients with atrial fibrillation?
RCT (n=32)
Does noninvasive ambulatory ECG monitoring provide comparable diagnostic value to implantable loop recorders in patients with atrial fibrillation?
Noninvasive 14-day ECG monitoring provides comparable diagnostic value to implantable loop recorders for detecting atrial fibrillation, with faster physician notification.
May expedite AF management via faster notification; extends RCT evidence for noninvasive over implantable monitoring.
OBJECTIVE: The objective of the study was to estimate the efficacy of a noninvasive ambulatory ECG monitoring (NIAM) in comparison with implantable loop recorder (ILR) in patients with atrial fibrillation (AF). METHODS: Thirty-two patients 58 [47; 73] years of age with AF were included in the study. Patients were randomized into two groups: in group I (n = 15), "Reveal XT" ILR was used for invasive ECG monitoring up to 3 months; in group II (n = 17), "Spyder" device was used for NIAM up to 14 days. RESULTS: In both groups, at least one AF episode was detected during 14 days of monitoring. The overall count of AF episodes was 25 in NIAM group and 28 in ILR group. The mean time between AF start and its registration by a physician was 8 hr in NIAM group and 20 hr in ILR group (p = .005). The diagnostic value parameters of NIAM were as follows: sensitivity-80.1%, specificity-73.1%; positive predictive value-74.1%; and negative predictive value-79.2%. The same parameters in ILR group were comparable with NIAM: sensitivity-78.6%; specificity-69%; positive predictive value-71%; and negative predictive value-77%. At the same time, continued monitoring with ILR for longer than two weeks did not lead to a significant change in the sensitivity and specificity of the method. CONCLUSION: In patients with paroxysmal AF, the diagnostic value of both NIAM and ILR is comparable. An increase in the duration of ECG monitoring for longer than two weeks does not provide additional diagnostic information.
No takes yet. Share an insight, caveat, or question.
Мамчур et al. (2019) conducted an RCT in Atrial fibrillation (n=32). Noninvasive ambulatory ECG monitoring (NIAM) vs. Implantable loop recorder (ILR) was evaluated on Mean time between AF start and its registration by a physician (hours) (p=.005). Noninvasive ambulatory ECG monitoring significantly reduced the mean time to physician registration of atrial fibrillation compared to an implantable loop recorder (8 vs 20 hours; p=0.005).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: