29 Sep Researchers Discuss Atrial Fibrillation and ZIO Service For Detection and Management
MedicalResearch.com Interview with:
Philip Gorelick, M.D., M.P.H, F.A.C.P.
Medical Director of the Hauenstein Neuroscience Center
Saint Mary’s Health Care, Grand Rapids, MI;
Professor, Translational Science and Molecular Medicine
Michigan State University College of Human Medicine;
Board member of the National Stroke Association
Judy Lenane, R.N., M.H.A.
Chief Clinical Officer of iRhythm Technologies, Inc.
Medical Research: What is atrial fibrillation and how common a problem is it among US adults?
Dr. Gorelick: Nearly 3 million people in the US suffer from Atrial Fibrillation or “Afib,” an abnormal heart rhythm that causes the heart to beat rapidly and irregularly. While Afib can occur at any age, the incidence increases with age and the number of cases is expected to increase significantly in the coming years as the population ages. Approximately 5 percent of people 65 years and older and one in every 10 people over 80 years of age have Afib. It is more common in those with high blood pressure, heart disease or lung disease.
Medical Research: How does atrial fibrillation affect a person’s health? Is it related to stroke or heart attack?
Dr. Gorelick: Afib can lead to heart failure and stroke if not detected and treated properly. People with Afib are five times more likely to have a stroke and Afib is believed to be a common underlying cause of the up to 30% of strokes that have no known cause.
A survey of 1,013 American adults by the National Stroke Association revealed that while nearly half (45%) of Americans are aware Afib may increase stroke risk, only 17% are aware of the extent of the astonishing (five-fold) increase in stroke risk caused by Afib.
Physicians need to know if stroke or TIA patients have an underlying cardiac arrhythmia, which may have caused their neurological event, as this will impact treatment to help prevent a recurrence.
Medical Research: How can atrial fibrillation be detected? Does a person always have symptoms of Afib?
Dr. Gorelick: Some people with Afib describe fluttering, racing or pounding sensations in their chests. Others may only experience dizziness, fainting, fatigue or light headedness during an episode. Often, Afib has no symptoms.
Dr. Gorelick: The National Stroke Association survey showed that only half of Americans are aware that heart palpitations and pounding, fluttering or racing sensations in the chest are symptoms of Afib and only a third or less are aware that shortness of breath (37%), dizziness or light-headedness (34%) and fatigue (27%) are also symptoms. Only 21% are aware Afib may have no symptoms at all, and 25% mistakenly believe chest pain is a symptom of Afib.
Diagnosing Afib in a patient includes ambulatory electrocardiogram (ECG) monitoring of cardiac activity and the rate of the heartbeat. However, traditional cardiac monitoring options, such as the Holter monitor, are limited in their ability to detect the condition. Since Afib may occur infrequently and often has no symptoms, these options do not capture enough data or record for a long enough period of time, are hard for patients to comply with and/or they are expensive.
New advances in digital health monitoring technologies are now enabling long-term continuous cardiac monitoring and data recording, providing options for more effective diagnosis.
Judy Lenane, R.N., M.H.A., is Chief Clinical Officer of iRhythm Technologies, Inc.:
Medical Research: How does the ZIO Service improved the detection and management of atrial fibrillation?
Judy Lenane: The ZIO® Service is a digital health solution from iRhythm Technologies (www.irhythmtech.com) for long-term continuous cardiac monitoring and recording. It is recognized as the new standard for identifying patients with Afib and other cardiac arrhythmias.
- The wearable ZIO® XT Patch biosensor is a noninvasive, water-resistant heart monitor that is easy to use and discrete to wear, and is worn to record heart beat data for up to 14 days, prompting high patient compliance and a higher diagnostic yield
- Proprietary algorithms analyze up to 2 million recorded heart beats per wear time to rule in and rule out cardiac arrhythmias, identify specific types of arrhythmia (e.g., atrial fibrillation) and capture disease burden.
- The secure, cloud-based ZIO Report provides physicians with unique, clinically actionable information to help guide treatment decisions.
The ZIO Service is the only long-term continuous monitoring and recording option that is proven in multiple, peer-reviewed published studies to improve cardiac arrhythmia diagnosis, including Afib, earlier in the clinical pathway and to change treatment decisions compared to traditional methods. This clinical evidence has led to rapid payer coverage and physician adoption.
A study presented at the 2014 International Stroke Conference showed that the ZIO Patch was worn by stroke and TIA patients for long periods of time, and that it identified a significant number of arrhythmia events that would have been missed by other monitors, due to their shorter wear times. In addition:
- A Scripps Translational Science Institute study, published in the American Journal of Medicine, showed that the ZIO Service identified 57% more heart arrhythmia events compared to the Holter monitor, primarily due to prolonged monitoring.
- In a study of more than 26,000 patients, published in the American Journal of Cardiology, the ZIO Service identified 30% of arrhythmias after 48 hours – the typical upper limit of wear time for the Holter monitor – meaning they would have been missed by the Holter.
- A prospective, comparative effectiveness study, published in the journal PACE, showed that use of the ZIO Service prompted change in atrial fibrillation clinical management in 28% of patients, compared to Holter monitoring.
- In a study, published in the Western Journal of Emergency Medicine, the ZIO Service had a higher diagnostic yield of 63% in low-risk patients discharged from the ED, compared to the 15% found with 24-48-hour Holter monitoring in previous studies.
September is National Atrial Fibrillation Awareness Month Survey results