Simulation of daily ECG monitoring strategies for atrial fibrillation patients

Patients with arrhythmias would greatly benefit from daily ECG monitoring, both for diagnosis and therapy optimization. The aim of this study was to simulate several ECG monitoring strategies which could help in optimizing a home monitoring device. Simulations were performed using data from patients implanted with DDD-CLS pacemaker for Brady-Tachy Syndrome (Burden II Study). The data analysis was performed considering the mode switch list which includes date, time and duration of each mode switch episode. Starting from this database, daily monitoring strategies were simulated by varying the hour of beginning and the duration of each daily recording, and the number of monitoring consecutive days. The number of detected patients varies depending on the hour of the day when the monitoring starts, with peaks in the morning (9-10 A. M.). The lowest number of detected patients is obtained at late evening (10-11 P. M.). An optimized 2-hour monitoring for 60 consecutive days can detect almost 60% of patients experiencing AF episodes in the observational period compared with 10% and 35% of detected patients with AF episodes obtained using one-day and 7-days Holter monitoring, respectively.