| Ambulatory ECG monitor type | Indications/patient selection |
| Continuous ECG monitor (ie, Holter monitor) | - Daily or near daily symptoms (palpitations)
- Assessment for adequate rate control in atrial fibrillation
- Assessment of VPB or APB burden, NSVT in hypertrophic cardiomyopathy
- Heart rate assessment for inappropriate sinus tachycadia, postural orthostatic tachycardia syndrome, suspected chronotropic incompetence
|
| Event (loop) monitor | - Less frequent symptoms (weekly or biweekly)
- Assessment for arrhythmic source of palpitations
- Assessment for arrhythmic source of dizziness or pre-syncope/syncope
- Assessment for atrial fibrillation (though asymptomatic episodes could be missed unless an auto-triggered event monitor is used)
|
| Patch monitor | - Daily, near daily, or weekly frequency of symptoms
- Assess arrhythmia burden (eg, atrial fibrillation, VPBs)
- Assess for NSVT in hypertrophic cardiomyopathy
- Assessment for atrial fibrillation as a source of cryptogenic stroke (diagnosis limited by length of time the monitor is worn)
|
| Mobile cardiac outpatient telemetry (MCOT) | - Assess arrhythmia burden (eg, atrial fibrillation, VPBs)
- Assessment for arrhythmic source of palpitations
- Assessment for arrhythmic source of dizziness or pre-syncope/syncope
- Assessment for atrial fibrillation as a source of cryptogenic stroke (diagnosis limited by length of time the monitor is worn)
|
| Implantable loop recorder | - Infrequent (less than monthly) symptoms associated with syncope or other high risk features
- Assessment for atrial fibrillation as a source of cryptogenic stroke
- Assessment for recurrence of atrial fibrillation (eg, post-ablation)
|
| Commercially available heart rate monitor (eg, wristbands, smartwatches) | |
| Commercially available heart rhythm monitors (eg, smartwatches, hand held devices, smartphone based electrode cards, etc) | - No approved indications
- Can be considered for monitoring for arrhythmic source or palpitations
- Can be considered for monitoring for symptomatic atrial fibrillation recurrence
|
| Clinical monitoring scenarios | Available monitoring options |
| Symptoms (palpitations) daily or near daily | - Continuous ECG monitor (Holter)
- Patch monitor
|
| Symptoms (palpitations) weekly or biweekly | - Event (loop) monitor
- Patch monitor
- MCOT
|
| Symptoms infrequently (monthly or less) associated with syncope or high risk features | - Implantable loop recorder
|
| Assessment for occult atrial fibrillation* | - Event (loop) monitor, ideally an auto-triggered event monitor
- Patch monitor
- MCOT
- Implantable loop recorder
|
| Assessment for arrhythmia burden (eg, VPB burden) or average heart rate (eg, AF, inappropriate sinus tachycardia, etc) | - Continuous ECG monitor (Holter)
- Patch monitor
- MCOT
|
