The feasibility of a serial 12-lead ECG wireless patch in the hospital setting

Background: Chest pain is the second most common reason to present to the emergency department in the United States, and the ECG is a first-line diagnostic tool for myocardial ischemia assessment. For patients with ongoing symptoms or unclear initial ECGs, guidelines recommend performing multiple standard ECGs at 15-30-min intervals during the first 1-2 h, which improves acute coronary syndrome (ACS) detection by 15 % and accelerates triage of high-risk ACS patients. However, obtaining serial ECG is not consistently practiced due to overcrowding and the limited technical abilities of current 12-lead ECG machines. This study aimed to evaluate an FDAapproved wireless 12-lead ECG patch for serial cardiac monitoring in the hospital setting. Methods: Prospectively, ECG patch was applied in the Mason-Likar electrode configuration after obtaining consent. The patch remained in place for at least one hour. Clinical Utility of the ECGs was categorized from 1 to 3: 1 = uninterpretable, 2 = borderline, and 3 = interpretable. Results: Among hospitalized cardiac patients, 28 consented to wear the ECG patch for at least one hour and patients were free to ambulate during the study. Most (70 %) patients were in sinus rhythm, and an episode of asymptomatic TMI was captured. The clinical utility of the ECGs (n = 364) was mostly interpretable, 64 % (n = 231), while 15 % (n = 55) were uninterpretable and 18 % (n = 65) were borderline. Most (69 %) preferred the patch, while 12 % preferred telemetry. The hospitalized cardiac patients reported significantly better ability to ambulate with the ECG patch (Z = -3.607, p < 0.001). Conclusion: Thus, this experiment demonstrated that the ECG patch provides quality serial ECG monitoring and captures TMI of hospitalized cardiac patients without increasing burden.