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Time to retire the Holter monitor? Long-term cardiac rhythm monitoring comes of age

Apr 26, 2012 09:45 EDT


What took so long? More than 60 years after the invention of the Holter monitor, new technologies are--finally!--stepping in to offer simple and innovative devices to monitor cardiac arrhythmias. Is this one a "keeper"?

Have you used this device? Share your comments below and vote in the "What's your verdict?" section at right.

Follow Dr Topol on Twitter: @erictopol

Dr Topol has no relationship with the manufacturer of this device.








Your comments
Time to retire the Holter monitor? Long-term cardiac rhythm monitoring comes of age
# 1 of 14
April 27, 2012 10:33 (EDT)
Carter Newton
Brilliant! Terrific next step would be Bluetooth functionality for daily surveillance elsewhere by forwarding daily data feeds to a collection site, Rhythms intelligently surveilled for pathology and issues forwarded to the responsible MD. Wish I had more info on this device.
# 2 of 14
April 27, 2012 11:07 (EDT)
Jeffrey Feiner
I've used this device several times. It's quite effective. The first generation of the device would not stay on the patient, however they have altered the adhesive. The biggest problem is reimbursement from insurance. On the last two I've used, after paying the company the scanning fee, my reimbursement was $2 less than the fee so I actually lost money. The technology isn't going to go very far if Cardiologists have to reach into their pockets just to use the device. But I still keep trying because I do like the technology especially for atrial fib burden
# 3 of 14
April 27, 2012 06:29 (EDT)
Cynthia Ferguson
Can't wait...holter has such limitations, next step I would like to see is patch that could downloaded at home in real time..still like idea of something in use for 1 full week..not just 24-48 hrs...
# 4 of 14
April 27, 2012 08:01 (EDT)
Jeffrey Patten
So much better than getting wired up! (Afib) I've had both. You can almost forget you've got a Zio for the two weeks. The only problem is understandable: an adhesive that lasts two weeks? Amazing! But the device does shift on your skin and start to itch near the end of the stint. I'll live with it.
# 5 of 14
April 27, 2012 08:40 (EDT)
Sarana Boonbaichaiyapruck
The way to go for accurate diagnosis.
# 6 of 14
April 29, 2012 12:31 (EDT)
Christopher LaVergne
Reimbursement is huge problem. Right now we have to pay $110 per device, we break even with Medicare and make a few buck on commercial insurance. But price now going to $220 per device. Outrageous!! Will completely prevent me from using it. Would lose money on every patient except a few commercial carriers. Nice device but will have to stop using it due to their pricing.
# 7 of 14
April 30, 2012 08:02 (EDT)
James Cooksey
Having worn quite a few Holters over the years myself, I would find this to be a tremendous improvement. Pricing is obviously an issue, but I wonder how it compares with conventional hookup and interpretation charges, to say nothing of time/money involved in transportation to and from the office?
# 8 of 14
May 3, 2012 09:35 (EDT)
Eric Topol
thanks for excellent points and perspective noted above. It will be interesting to see how the cost issues get settled, and hopefully soon we will have data on yield vs 24 h Holter. The adhesive clearly works pretty well, and the convenience factor for the patient is quite impressive.
# 9 of 14
May 7, 2012 11:32 (EDT)
Rahul Sawant
Excellent product.I am sure it will take off along with smart phone app or wireless 4 G remote date monitoring.
# 10 of 14
May 11, 2012 04:23 (EDT)
ELVA ROBERT
Definitely a need for t he future, true readings for the patient ot just 12 - 24 hours, the monitor placed at a time of relaxation, no stress,no exercise the IMperfect time, 3 days to a week would produce the results needed. at last future is more positive.
# 11 of 14
May 11, 2012 04:26 (EDT)
ELVA ROBERT
perfect solution for perfect results. picking up all arrhythmias, at normal times, not just at a time of no stress, relaxation, no exercise, thus no real results. 3 to 7 days would result in every response, all A.F. ..at last the future is positive.
# 12 of 14
May 11, 2012 04:26 (EDT)
ELVA ROBERT
perfect solution for perfect results. picking up all arrhythmias, at normal times, not just at a time of no stress, relaxation, no exercise, thus no real results. 3 to 7 days would result in every response, all A.F. ..at last the future is positive.
# 13 of 14
May 15, 2012 10:52 (EDT)
David Bach
And what happened to Microvolt T-Wave Alternans (MTWA) to determine susceptibility to sudden cardiac arrest? It's non-invasive, results are obtained in 30 minutes, it has FDA approval and a reimbursement code, and NASA uses it on astronauts. For more information about MTWA, go to www.cambridgeheart.com.
# 14 of 14
October 27, 2012 08:33 (EDT)
Melissa Walton-Shirley
Looks like a great device and excited to see the data coming down the pike. BUT.... I love real-time monitoring. Just started to use ecardio in the last couple of months (I have no disclosures). Within the first week of ordering thirty day monitors-diagnosed many with afib RVR who would have been missed with a 24 hour monitor. A traditional event monitor would not have caught them. Although they had come for palpitory awareness or other symptoms, almost 100% had NO symptoms during their periods of arrhythmia. Yesterday, handed a strip with non sustained wide complex tachycardia-again, no symptoms and on her 20th day of monitoring. Like the concerns echo'd above, I was getting reimbursed for the event monitors, holters, etc. but with real time monitoring, I'm not seeing the reimbursement that was advertised. I am hoping the patient will not have out of pocket cost-but yet to be seen. Real time monitoring is the holy grail of arrhythmia detection-certainly works but our system of reimbursement with multiple payers may kill this extremely efficacious innovation. I will bet it is cost effective, but am unaware of any studies that support that in our system. If just one stroke saved........

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