Wearable Patch ECG monitors and transesophageal electrophysiological study for diagnosing palpitations of unknown origin.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Frontiers in Cardiovascular Medicine Pub Date : 2024-11-13 eCollection Date: 2024-01-01 DOI:10.3389/fcvm.2024.1469108

Ruike Yang, Lihong Yang, Qiang Zhang, Shuhui Wang, Jinyi Xu

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Abstract

Objective: To analyze the application value of wearable adhesive Patch ECG monitors combined with transesophageal electrophysiological study (TEPS) in the diagnosis of palpitations of unknown origin.

Methods: This was a retrospective study of patients with suspected arrhythmia who were admitted to Henan Provincial People's Hospital between October 2021 and July 2023 due to recurrent paroxysmal palpitations of unknown origin, with or without accompanying symptoms such as dizziness, amaurosis, and syncope. All patients underwent TEPS. Those who did not exhibit arrhythmia during the TEPS were selected for Patch ECG monitoring, which lasted several weeks (depending on the duration of symptom capture). The results of TEPS, Patch ECG monitors, and clinical diagnoses were observed and recorded. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (NPV) for diagnosing palpitations of unknown origins was analyzed based on clinical diagnostic outcomes for (1) TEPS alone, (2) Patch ECG monitoring in patients with negative TEPS results, and (3) the combination of both methods.

Results: A total of 569 patients were included in this study. The TEPS results exhibited that 227 of the 569 patients did not detect arrhythmias and 342 detected arrhythmias. Of the 569 patients, 102 refused to undergo Patch ECG monitors, and 467 patients completed the entire study process. Among them, 379 cases (66.61%) were clinically diagnosed as arrhythmias. TEPS shows good performance in most evaluation indices except NPV (69.60%, 95% CI, 61.54%-77.66%). The combined diagnosis was strongly consistent with clinical diagnosis. The accuracy, sensitivity, and NPV of TEPS combined with Patch ECG monitors in the diagnosis of palpitations of unknown origin were significantly higher than those of TEPS alone.

Conclusion: Wearable adhesive patch ECG monitors combined with TEPS can enhance the diagnostic efficiency of palpitations of unknown origin.

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用于诊断不明原因心悸的可穿戴式贴片心电图仪和经食管电生理研究。

目的分析可穿戴式贴片心电监护仪联合经食管电生理检查（TEPS）在不明原因心悸诊断中的应用价值：这是一项回顾性研究，研究对象为2021年10月至2023年7月期间因反复发作原因不明的阵发性心悸，伴有或不伴有头晕、头昏、晕厥等症状而入住河南省人民医院的疑似心律失常患者。所有患者都接受了 TEPS。那些在 TEPS 期间未表现出心律失常的患者被选中接受贴片心电图监测，监测持续数周（取决于症状捕获的持续时间）。对 TEPS、贴片心电图监测结果和临床诊断进行观察和记录。根据以下临床诊断结果分析了诊断不明原因心悸的敏感性、特异性、准确性、阳性预测值和阴性预测值（NPV）：（1）单独使用 TEPS；（2）对 TEPS 结果为阴性的患者进行贴片心电图监测；（3）两种方法的结合：本研究共纳入了 569 名患者。TEPS 结果显示，569 例患者中有 227 例未检测到心律失常，342 例检测到心律失常。在 569 名患者中，102 人拒绝接受 Patch 心电图监测，467 人完成了整个研究过程。其中，379 例（66.61%）临床诊断为心律失常。除 NPV（69.60%，95% CI，61.54%-77.66%）外，TEPS 在大多数评价指标上表现良好。综合诊断与临床诊断高度一致。在诊断不明原因心悸时，TEPS 与贴片式心电图监测仪联合使用的准确性、灵敏度和 NPV 都明显高于单独使用 TEPS 时的准确性、灵敏度和 NPV：结论：可穿戴式贴片心电图监测仪与 TEPS 联用可提高不明原因心悸的诊断效率。

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来源期刊

Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.80

自引率

11.10%

发文量

3529

审稿时长

14 weeks

期刊介绍： Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.