Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2025 May;30(3):e70068.
doi: 10.1111/anec.70068.

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

Dillon J Dzikowicz  1   2 , Mehmed Aktas  2 , Betty Mykins  2 , Xiaojuan Xia  2 , Wojciech Zareba  2 , Jean-Phillippe Couderc  2
Affiliations
Clinical Trial

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

Dillon J Dzikowicz et al. Ann Noninvasive Electrocardiol. 2025 May.

Abstract

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.

Keywords: diagnostic techniques and procedures; electrocardiography ambulatory; heart function tests; monitoring ambulatory.

PubMed Disclaimer

Conflict of interest statement

Wojciech Zareba is an Editorial Board member of Annals of Noninvasive Electrocardiology and a co‐author of this article. To minimize bias, they were excluded from all editorial decision‐making related to the acceptance of this article for publication.

Figures

FIGURE 1
FIGURE 1
Panels (A), (B), and (C) show a 7‐beat ECG collected from days 1, 7, and 14, respectively, from a 57‐year‐old male (BMI 25 kg/m2) who had high compliance with the ECG patch. Given his high compliance, the interpretability of the ECG recordings is maintained as exhibited in the figure.
FIGURE 2
FIGURE 2
BMI negatively impacts wear time compliance with a 14‐day ECG patch.
See this image and copyright information in PMC

References

    1. Barrett, P. M. , Komatireddy R., Haaser S., et al. 2014. “Comparison of 24‐Hour Holter Monitoring With 14‐Day Novel Adhesive Patch Electrocardiographic Monitoring.” American Journal of Medicine 127, no. 1: 95.e11–95.e17. - PMC - PubMed
    1. Boriani, G. , Laroche C., Diemberger I., et al. 2015. “Asymptomatic Atrial Fibrillation: Clinical Correlates, Management, and Outcomes in the EORP‐AF Pilot General Registry.” American Journal of Medicine 128, no. 5: 509. - PubMed
    1. Bouzid, Z. , Al‐Zaiti S. S., Bond R., and Sejdic E.. 2022. “Remote and Wearable ECG Devices With Diagnostic Abilities in Adults: A State‐of‐the‐Science Scoping Review.” Heart Rhythm 19, no. 7: 1192–1201. - PMC - PubMed
    1. Campero Jurado, I. , Lorato I., Morales J., et al. 2023. “Signal Quality Analysis for Long‐Term ECG Monitoring Using a Health Patch in Cardiac Patients.” Sensors 23, no. 4: 2130. - PMC - PubMed
    1. Cheung, C. C. , Kerr C. R., and Krahn A. D.. 2014. “Comparing 14‐Day Adhesive Patch With 24‐h Holter Monitoring.” Future Cardiology 10, no. 3: 319–322. - PubMed

Publication types

Associated data