Heart monitor patch5/1/2023 However, if an index event of clinical significance, such as syncope, occurs, the patch can simply be removed and returned for earlier rhythm analysis. Generally, patients are instructed to keep the patch in place for up to 14 days of continuous recording. The patch is removed by the patient, without medical assistance, and returned in a small preaddressed box that accompanies the patch (Figure 2). Due to its ease-of-application, devices can be stored in locations where prompt application may increase the likelihood of making a timely diagnosis, such as upon discharge from emergency rooms, outpatient clinics and primary care offices. Other aspects of the Zio Patch model are also revolutionary in concept. Studies have demonstrated a significantly less than 1% water damage rate under normal use. The Zio Patch can be worn continuously, even when bathing. Another limitation of the Holter concept results from the need to disconnect the wires and electrodes for the patient to be able to shower or exercise, situations in which rhythm abnormalities may occur undetected. The traditional Holter monitor requires external wires and electrodes, which limit patient acceptance and ease-of-use. It is 'wireless', that is, it does not require the need for electrode wires. The Zio Patch provides many other advantages to the Holter monitor besides length of recording. IRhythm Zio® Patch (iRhythm Technologies, Inc., CA, USA). Similar to other ECG recording devices, the frequency response is 0.15–34 Hz, input impedence >3 Mohm, differential range ☑.65 mV and resolution 10 bits. The Zio Patch is a single-channel continuous recording format with a memory of up to 14 days of stored rhythms. The typical Holter monitor recording only comprises 24–48 h. The Zio Patch has been referred to as a 'big Band-Aid®' (Johnson & Johnson, NJ, USA) since it is only 2 × 5 inches in size, complete with electrodes, recording hardware and software, an event button for marking the time of symptoms and an adhesive that typically allows for continuous recording for up to 14 days. Kumar and his team developed a new concept which he subsequently commercialized: a single-use, recyclable, single-channel recording patch called the Zio® Patch (iRhythm Technologies, Inc., CA, USA Figure 1). In 2006, a young cardiac electrophysiologist, Uday N Kumar, and others at the Stanford University Biodesign program (CA, USA) recognized that current monitoring technologies, including the Holter monitor, were ripe for a disruptive technological advance. Such potentially revolutionary opportunities have only recently become possible as a result of technologic advances. Additional current and future advances in heart rhythm recording are also discussed. Its ease-of-use, which enables optimal long-term monitoring, has been established in the ambulatory setting, although some insurance carriers have been reluctant to reimburse appropriately for this advance, an issue characteristic of other heart monitors, treated as 'loss-leaders.' In this article, in addition to discussing possible reasons for this reluctance, a novel model for direct-to-consumer marketing of heart monitoring, outside of the traditional health insurance reimbursement model, is also presented. One promising advance is the Zio® Patch (iRhythm Technologies, Inc., CA, USA), a small 2 × 5-inch patch, which can continuously record up to 14 days of a single ECG channel of cardiac rhythm without the need for removal during exercise, sleeping or bathing. A number of substantial improvements to the 60-year-old concept of the Holter monitor have recently been developed.
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