Identifying Demographic Factors Affecting the ECG Duration Collected Using a Single‐Lead ECG Patch Device

INTRODUCTION: Atrial fibrillation (AF), affecting 3% of the US adults, is the most common arrhythmia. While ambulatory electrocardiogram (ECG) monitoring is essential for AF detection, conventional technologies have diagnostic limitations due to AF's sporadic nature. ECG patches offer extended monitoring periods, though their effectiveness is primarily limited by deteriorating skin-electrode contact rather than battery or memory constraints. OBJECTIVES: This analysis reports our experience with the Zio ECG patch (iRhythm, San Francisco, CA) in 256 AF patients. METHOD: We analyzed human and technical factors and their association with ECG recording duration using previously recorded data which employed the ECG patch as a reference. Descriptive statistics and logistic regression were used to identify associations. RESULTS: Body mass index (BMI) was found to be an independent predictor of poorer compliance in a dose-dependent manner (B = -0.046, OR = 0.955, 95% CI: 0.916-0.996, p = 0.033). Loss of adhesive was the primary reason for poor compliance (n = 25; 11%). These findings can guide researchers and clinicians in determining the appropriateness of a 14-day ECG patch based on expected wear time and patient compliance. CONCLUSION: BMI significantly impacts ECG patch compliance, primarily through adhesive failures. These findings indicate the need for improved adhesive technologies for higher BMI patients. Future device development should prioritize maintaining electrode-skin contact across diverse patient populations. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04267133.