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
. 2025 Jul 21;40(28):e168.
doi: 10.3346/jkms.2025.40.e168.

A Patch-Type Electrocardiography Is Superior to Holter Monitoring for Detecting Paroxysmal Cardiac Arrhythmias

Yun Gi Kim  1 , Jong-Il Choi  2 , Il-Young Oh  3 , Joo Hee Jeong  1 , Hyoung Seok Lee  1 , Yun Young Choi  4 , Ji Hyun Lee  4 , Youngjin Cho  4 , Jaemin Shim  1 , Ho Sung Son  5 , Young-Hoon Kim  1
Affiliations

A Patch-Type Electrocardiography Is Superior to Holter Monitoring for Detecting Paroxysmal Cardiac Arrhythmias

Yun Gi Kim et al. J Korean Med Sci. .

Abstract

Background: Patch-electrocardiography (ECG) enables prolonged ECG monitoring beyond 24 hours. However, diagnostic yield between patch-ECG and Holter monitoring needs further validation. We aimed to compare diagnostic capabilities of 14-day patch-ECG and one day Holter monitoring to detect cardiac arrhythmias.

Methods: Patients with suspected cardiac arrhythmias but could not be diagnosed by 12-lead ECG were enrolled from two tertiary centers. Patch-ECG and Holter monitoring was attached simultaneously in enrolled patients. Primary endpoint was detection of major arrhythmias which was defined as atrial fibrillation (AF), atrial tachycardia, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), ventricular tachycardia, 2nd or 3rd degree atrioventricular block, sick pause (> 2 seconds of pause), sick sinus syndrome, tachycardia-bradycardia syndrome, and Wolff-Parkinson-White syndrome.

Results: A total of 147 patients were analyzed. Major arrhythmias were detected in 75.5% and 48.3% in patch-ECG and Holter monitoring, respectively (P < 0.001). Detection rate between the first day of patch-ECG and Holter monitoring was identical. Detection rate for AF was significantly higher in patch-ECG (23.8% vs. 11.6%; P < 0.001). Substantial proportion of AF events were detected in the first day of monitoring (42.9%) but diagnosis rate increased steadily between day 2-14 of monitoring. Detection rate of supraventricular tachycardia (atrial tachycardia or PSVT), ventricular tachycardia, and brady-arrhythmias was higher in the patch-ECG. Four patients had to detach their patch-ECG due to skin side effects.

Conclusion: Patch-ECG has higher diagnostic capabilities compared to Holter monitoring for diagnosis of various cardiac arrhythmias.

Keywords: Arrhythmia; Electrocardiography; Holter Monitor; Patch-ECG; Wearable Device.

PubMed Disclaimer

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Patch ECG used in this study. Real model image and actual recorded ECG are presented. During AF status, fibrillatory waves were clearly identified. P-wave was well recorded during sinus rhythm.
ECG = electrocardiography, AF = atrial fibrillation.
Fig. 2
Fig. 2. Study flow of subjected patients.
Fig. 3
Fig. 3. Skin side-effects by patch-ECG.
ECG = electrocardiography.
Fig. 4
Fig. 4. Fourteen-day patch-ECG vs. Holter monitoring. Cumulative detection of major arrhythmia events (A) and atrial fibrillation (B) by 14-day patch ECG are depicted. Patch ECG showed comparable detection rate of AF compared with Holter monitoring in the first and second day of analysis.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kim YG, Choi JI, Kim HJ, Min K, Choi YY, Shim J, et al. A watch-type electrocardiography is a reliable tool for detecting paroxysmal cardiac arrhythmias. J Clin Med. 2022;11(12):3333. - PMC - PubMed
    1. Freedman B, Potpara TS, Lip GY. Stroke prevention in atrial fibrillation. Lancet. 2016;388(10046):806–817. - PubMed
    1. Anter E, Jessup M, Callans DJ. Atrial fibrillation and heart failure: treatment considerations for a dual epidemic. Circulation. 2009;119(18):2516–2525. - PubMed
    1. Kamel H, Okin PM, Elkind MS, Iadecola C. Atrial fibrillation and mechanisms of stroke: time for a new model. Stroke. 2016;47(3):895–900. - PMC - PubMed
    1. Kim YG, Lee HS, Kim H, Kim M, Jeong JH, Choi YY, et al. Association of antiarrhythmic drug therapy with syncope and pacemaker implantation in patients with atrial fibrillation. J Am Coll Cardiol. 2024;83(11):1027–1038. - PubMed