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{
    "pk": 7905,
    "title": "Ambulatory Cardiac Monitoring for Discharged Emergency Department Patients with Possible Cardiac Arrhythmias",
    "subtitle": null,
    "abstract": "Introduction: Many emergency department (ED) patients have symptoms that may be attributed to arrhythmias, necessitating outpatient ambulatory cardiac monitoring. Consensus is lacking on the optimal duration of monitoring. We describe the use of a novel device applied at ED discharge that provides continuous prolonged cardiac monitoring.\nMethods: We enrolled discharged adult ED patients with symptoms of possible cardiac arrhythmia. A novel, single use continuous recording patch (Zio®Patch) was applied at ED discharge. Patients wore the device for up to 14 days or until they had symptoms to trigger an event. They then returned the device by mail for interpretation. Significant arrhythmias are defined as: ventricular tachycardia (VT) ≥4 beats, supraventricular tachycardia (SVT) ≥4 beats, atrial fibrillation, ≥3 second pause, 2nd degree Mobitz II, 3rd degree AV Block, or symptomatic bradycardia.\nResults: There were 174 patients were enrolled and all mailed back their devices. The average age was 52.2 (± 21.0) years, and 55% were female. The most common indications for device placement were palpitations 44.8%, syncope 24.1% and dizziness 6.3%. Eighty-three patients (47.7%) had ≥1 arrhythmias and 17 (9.8%) were symptomatic at the time of their arrhythmia. Median time to first arrhythmia was 1.0 days (IQR 0.2-2.8) and median time to first symptomatic arrhythmia was 1.5 days (IQR 0.4-6.7). 93 (53.4%) of symptomatic patients did not have any arrhythmia during their triggered events. The overall diagnostic yield was 63.2%\nConclusion: The Zio®Patch cardiac monitoring device can efficiently characterize symptomatic patients without significant arrhythmia and has a higher diagnostic yield for arrhythmias than traditional 24-48 hour Holter monitoring. It allows for longer term monitoring up to 14 days. [West J Emerg Med. 2014;15(2):194–198.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "syncope"
        },
        {
            "word": "palpitations"
        },
        {
            "word": "Arrhythmia"
        },
        {
            "word": "ambulatory cardiac monitoring"
        },
        {
            "word": "Holter monitor"
        },
        {
            "word": "Emergency Medicine"
        },
        {
            "word": "cardiology"
        }
    ],
    "section": "Prehospital Care",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/50f7t7k5",
    "frozenauthors": [
        {
            "first_name": "Donald",
            "middle_name": "",
            "last_name": "Schreiber",
            "name_suffix": "",
            "institution": "Division of Emergency Medicine, Stanford University School of Medicine, Stanford, California",
            "department": "None"
        },
        {
            "first_name": "Ayesha",
            "middle_name": "",
            "last_name": "Sattar",
            "name_suffix": "",
            "institution": "Division of Emergency Medicine, Stanford University School of Medicine, Stanford, California",
            "department": "None"
        },
        {
            "first_name": "Dorian",
            "middle_name": "",
            "last_name": "Drigalla",
            "name_suffix": "",
            "institution": "Department of Emergency Medicine, Texas A&M College of Medicine, Temple,Texas",
            "department": "None"
        },
        {
            "first_name": "Steven",
            "middle_name": "",
            "last_name": "Higgins",
            "name_suffix": "",
            "institution": "Department of Cardiology, Scripps Memorial Hospital, La Jolla, California",
            "department": "None"
        }
    ],
    "date_submitted": "2013-07-12T01:32:29-07:00",
    "date_accepted": "2013-07-12T01:32:29-07:00",
    "date_published": "2014-02-28T13:46:55-08:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/7905/galley/4591/download/"
        }
    ]
}