Not all Ambulatory Cardiac Monitors are the same – What to consider when choosing a solution.

An optimal patient experience leads to better compliance thus improving the quantity and quality of data used for diagnosis. Ambulatory cardiac monitors are, of course, each designed differently. Understanding placement, preparation and published evidence relating to patient compliance is important. Ultimately the need is for a device that patients will wear for the full prescribed time, uninterrupted, providing the evidence required for diagnosis. Can patients continue with their daily activities (exercising, showering, etc.), knowing the device is still capturing every heartbeat? Do leads/wires or batteries need replacing or recharging during the prescribed wear time, potentially leading to interruptions in data collection? What is the evidence on patient compliance; will my patients wear the device for the prescribed period?

Take Zio; designed with patients in mind, it is a user-friendly monitor that minimises disruption and maximises compliance. 98% of patients wear Zio XT for the prescribed period¹, ensuring you get uninterrupted data to help make a fast and accurate diagnosis.

A major consideration is the quality of the finished report provided. These differ greatly from company to company and provide you with varying degrees of information, having been interpreted in a variety of ways. iRhythm takes pride on the quality of the report; after all it supports the clinical diagnosis so it’s essential

that the information presented to you is clinically actionable and trusted.

Zio XT provides highly accurate data analysed by our AI algorithm and overseen by iRhythm’s highly qualified cardiac physiologists¹. This process produces a high quality report to help you make the right diagnosis first time. With 99.9% clinician agreement, the accuracy of the Zio report frees-up valuable resources and ultimately expedites patient care¹.

Price is always a factor when choosing a new device or service for clinics and hospitals. Ambulatory ECG devices are no exception. Zio, has the potential to reduce the overall cost of service as shown by NICE. The array of devices on the market varies greatly in price, but there are many factors to consider when making a choice. Some devices will require ECG electrodes, lead wires and consumables such as prep tape and razors to be added to the cost. There may be additional service costs, such as the software required for analysis and an associated ongoing service contract. If analysis is undertaken by the hospital, the cost of staff resources should also be considered. Another factor is the amount of repeat testing that occurs with Holter devices. This typically runs at around 24% in NHS Trusts which itself has a considerable cost implication. So clearly, cost should not just be attributed to the device, but the value that service provides across the full clinical pathway. This is evident when clinical, operational and financial outcomes are factored into the equation. Only then can one truly demonstrate the value such a service brings to a hospital or clinic.

Zio is already demonstrating how it reduces the cost of care in the NHS³ in several Trusts across the country. The value it provides is felt across the full patient pathway. It is also having a perhaps unexpected impact by reducing the need for more costly and invasive procedures such as ILRs.

Further consideration should be given to the company offering the product. Do they have the infrastructure to accommodate the number of tests required in a reasonable timescale? Can they easily scale up their business? Are they CQC registered? Are they a direct operation or a distributor? iRhythm prides itself as the developer of Zio and its AI analysis algorithm.

The company has spent many years providing an accurate and reliable service upon which clinical teams can rely⁵. Part of the selection process should always be an assessment of the company itself. Hospitals and clinics want to be safe in the knowledge that the company selected is a secure and trusted organisation with which they can partner for many years.

Not all ambulatory ECG monitors are created equal. Zio, NHSx AI award winner and the only NICE-recommended service of its kind, as a result remains unrivalled on the market. Given the growth of the backlog across the NHS and the burden it is placing on cardiology services, the need for speed in diagnosis, as provided by Zio, has never been greater. Furthermore, The British Heart Foundation has warned that waiting lists for cardiovascular disease diagnosis and treatment could more than double within two years.

iRhythm is committed to supporting the need for diagnosing arrhythmias fast and accurately. By putting patients first we strive to improve clinical, operational and financial efficiencies. There’s no doubt that novel healthcare technology can help many of the NHS’ challenges. However, distinguishing between the potential benefits of different solutions and accelerating the path to widespread adoption is critical for success. In the case of ambulatory cardiac monitoring, clearly not all ECG monitors are the same. It’s imperative therefore, that careful thought is given to the type of device selected, not just for the short term, but for the long term.

iRhythm is a leading digital health care company redefining the way cardiac arrhythmias are clinically diagnosed. The company combines wearable biosensor devices worn for up to 14 days and cloud-based data analytics with powerful proprietary algorithms that distil data from millions of heartbeats into clinically actionable information. The company believes improvements in arrhythmia detection and characterization have the potential to change clinical management of patients.

For further information, please visit irhythmtech.co.uk

1. Data on file. iRhythm Technologies, 2019
2. Turakhia et al; Diagnostic Utility of a Novel Leadless Arrhythmia Monitoring Device. Am J Cardiol 2013
3.  NHS Case Study as part of the NHSx AI Award – more information can be provided
4. Clinical Publication Summary, iRhythm Technologies, 2020
5. NICE Guidance on Zio XT: https://www.nice.org.uk/guidance/mtg52/chapter/1-Recommendations
6. Artificial intelligence algorithms optimized from 3M+ patient data curated by certified cardiographic techinicians.