The advantages of using transtelephonic ECG monitoring device in outpatients with paroxysmal form of atrial fibrillation

To investigate the advantages of using a portable transtelephonic electrocardiographic (ECG) monitoring device in outpatients with paroxysmal atrial fibrillation (AF).

We examined 123 patients (45 men, 78 women, mean age, 63 [55;68] years) with paroxysmal AF with an average frequency of arrhythmia episodes of 3,0 [1;8] per month. Fifty four (44%) patients prescribed to use transtelephonic ECG monitoring device were included in the remote monitoring (RM) group (and sixty nine (56%) patients were included in the conventional monitoring (CM) group. Patients underwent scheduled examinations 2, 6 and 12 months after the start of therapy. Unscheduled consultations were carried out in case of AF recurrence. In addition to that patients from the RM group by means of transtelephonic ECG monitoring device, additionally registered ECG 1 time per week and in case of symptoms suggestive of AF recurrence. ECG strips were sent to investigators for analysis.

By dint of transtelephonic ECG monitoring device 3601 ECG strips were collected and analyzed: 3251 (90,3%) of them presented with sinus rhythm, 350 (9,7%) — with AF and atypical atrial flutter. Fifty four episodes of AF in 3 patients were asymptomatic. In addition, 309 (8,6%) sinus rhythm ECG strips were recorded by 20 patients with symptoms suggestive of AF. In the RM group, 9 (16,7%) patients were hospitalized due to recurrent AF, while in the CM group, 28 (40,6%) patients (p=0,004). The total number of emergency hospitalizations was 10 and 28 in the RM and CM groups, respectively. The number of patients who called an emergency medical services was lower in the RM group: in the CM group 46 calls for an ambulance were made by 29 patients, while in the RM group — 14 patients made 17 calls (p=0,034).

Remote ECG self-monitoring using the ECG monitoring system is a useful way to monitor patients with paroxysmal AF, which made it possible to register asymptomatic AF episodes, differentiate the causes of palpitation, and significantly reduce the frequency of emergency calls and hospitalizations.