DTA

Digital Theses Archive

 

Tesi etd-03292019-114230

Type of thesis
Perfezionamento
Author
BENEDETTI, GIOVANNI
E-mail address
giovannibenedetti@me.com
URN
etd-03292019-114230
Title
Wearable devices for health monitoring: use of an innovative adhesive thoracic patch in out-of-hospital settings
Scientific disciplinary sector
MED/11
Course
SCIENZE MEDICHE - Translational Medicine
Committee
Membro Prof. EMDIN, MICHELE
Membro Prof. VANELLO, NICOLA
Membro Prof. PASSINO, CLAUDIO
Membro Prof. MASI, GIANLUCA
Membro Prof. TADDEI, STEFANO
Keywords
  • wearable devices
  • adhesive thoracic patch
  • ECG monitoring
  • health monitoring
  • atrial fibrillation
  • ventricular tachycardia
Exam session start date
;
Availability
parziale
Abstract
BACKGROUND Over the last years, wearable devices (WDs) have emerged as autonomous and non-intrusive tools for health monitoring. Our systematic review has shown an increasing interest regarding WD technology and potential applications from 2000 up to 2015. Previously published studies were small single-centre studies with wrist and chest anatomic areas the most frequently considered. <br>AIMS To investigate the portability, quality of recording and diagnostic role of an innovative wearable thoracic patch device for prolonged electrocardiographic (ECG) monitoring.<br>METHODS We evaluated a new wearable device for continuous ECG monitoring named RootiRx (RootiLabs, Taipei, Taiwan) in healthy subjects for a mean duration of 5 days in order to assess device applicability and tolerability, subject compliance and ECG registration quality. Subsequently, results were compared in consecutively enrolled patients with a clinical indication for continuous ECG monitoring (brady- or tachyarrhythmia query). Patient compliance, registration quality and arrhythmia detection were analysed. 24-hour ECG Holter recording diagnostic findings were compared with RootiRx diagnostic findings in a subgroup. Finally, RootiRx diagnostic ability was assessed in post mitral valve surgery patients, given their high pre-test arrhythmia probability.<br>RESULTS In healthy subjects, ECG registration duration was 4,3 ± 0,9 days. In 6,5% of cases a premature interruption due to incidental patch detachment occurred. Excellent monitoring compliance was seen without cases of premature interruption of registration due to intolerance. In 2 cases, significant bradyarrhythmias were detected with significant pause due to 2° degree atrioventricular block. In 86 consecutive patients, registration duration, quality and compliance were excellent and similar to the first group. Monitoring duration was 4,5 days and patch intolerance 1%. In the subgroup of 28 patients were 24 ECG Holter recording data were compared with RootiRx, the later showed a non-inferiority diagnostic ability being able to detect paroxysmal supraventricular tachycardia (PSVT)/atrial fibrillation (AF) in 39,3% of patients, ventricular tachycardia (VT)/high-burden ventricular ectopic beats (VEB) in 28,6% and atrio-ventricular blocks (AVB)/pause 7%. No significant differences between 24 ECG Holter recording and RootiRx findings were found. In the final group of 15 mitral valve repair patients, RootiRx monitoring documented more frequently arrhythmic events with respect to healthy subjects: 33% of mitral valve repair patients with VT/high burden VEB episodes vs 0% in healthy subjects (p 0,04) and 53% of patients with AF/PSVT vs 13% in healthy subjects (p 0,05). <br>CONCLUSIONS RootiRx is a novel, multi-parametric wearable patch device for long-term ECG monitoring. In our out-of-hospital experience, RootiRx has been well tolerated and able to correctly identify cardiac arrhythmias with a diagnostic accuracy comparable to 24-hour ECG Holter recordings. The innovative characteristics of the device permit its use in multiple settings, even in patients at high risk of arrhythmia, such as post cardiac surgery patients.<br>
Files