ESOC 2023 Abstract Book

Background and aims: Atrial fibrillation (AF) causes up to 30% of ischaemic stroke, and earlier detection results in faster anticoagulation reducing stroke recurrence. We compared conventional Holter monitoring with Zio patches to assess detection rates, time from request to result, and the impact on outpatient appointments.<br/><br/>Methods: we retrospectively compared 339 patients who underwent standard Holter monitoring with 349 patients who had a Zio patch applied for 14 days. Zio patches were fitted as inpatients or sent to patients’ homes for self-application, whereas Holter monitoring required separate hospital attendance for fitting and removal.<br/><br/>Results: AF was detected in 7.2% in the Zio group compared with 3.2% in the Holter group. 32% of AF was detected in Zio patches applied within 48hrs of stroke, suggesting a benefit from early hyperacute monitoring. With Holter, average time from referral to test was 42 days and 58 days to result, compared with 29 days and 51 days with Zio. With Zio, mean time to AF detection was 6.3 days and wear time 13.4/14 days (95% of target wear time). 41% of patients with Holter monitoring needed face to face follow-up cardiology appointments compared with 19% with Zio.<br/><br/>Conclusions: Zio patches detected more than double the rates of AF compared with usual Holter monitoring. Diagnostic yield was highest within 48hrs of stroke. Time to result was faster, with earlier anticoagulation. Patients did not need to attend hospital for Zio patch fitting and the need for follow up appointments was halved compared with usual monitoring.