The aims of this study were (1) to identify research publications studying noninvasive electrocardiogram (ECG) monitoring devices, (2) to define and categorize current technology in noninvasive ECG recording, and (3) to discuss desirable noninvasive recording features for personalized syncope evaluation to guide technological advancement and future studies. We performed a systematic review of the literature that assessed noninvasive ECG-monitoring devices, regardless of the reason for monitoring. We performed an Internet search and corresponded with syncope experts and companies to help identify further eligible products. We extracted information about included studies and device features. We found 173 relevant papers. The main reasons for ECG monitoring were atrial fibrillation (n = 45), coronary artery disease (n = 10), syncope (n = 8), palpitations (n = 8), other cardiac diseases (n = 67), and technological aspects of monitoring (n = 35). We identified 198 devices: 5 hospital telemetry devices, 12 patches, 46 event recorders, 70 Holter monitors, 23 external loop recorders, 20 mobile cardiac outpatient telemetries, and 22 multifunctional devices. The features of each device were very heterogeneous. There are a large number of ECG-monitoring devices with different features available in the market. Our findings may help clinicians select the appropriate device for their patients. Since there are only a few published articles analyzing their usefulness in syncope patients, further research might improve their use in this clinical setting.

References

References
1.
Brignole
,
M.
,
Moya
,
A.
,
de Lange
,
F. J.
,
Deharo
,
J.-C.
,
Elliott
,
P. M.
,
Fanciulli
,
A.
,
Fedorowski
,
A.
,
Furlan
,
R.
,
Kenny
,
R. A.
,
Martín
,
A.
,
Probst
,
V.
,
Reed
,
M. J.
,
Rice
,
C. P.
,
Sutton
,
R.
,
Ungar
,
A.
,
van Dijk
,
J. G.
,
Torbicki
,
A.
,
Moreno
,
J.
,
Aboyans
,
V.
,
Agewall
,
S.
,
Asteggiano
,
R.
,
Blanc
,
J.-J.
,
Bornstein
,
N.
,
Boveda
,
S.
,
Bueno
,
H.
,
Burri
,
H.
,
Coca
,
A.
,
Collet
,
J.-P.
,
Costantino
,
G.
,
Díaz-Infante
,
E.
,
Delgado
,
V.
,
Dolmans
,
F.
,
Gaemperli
,
O.
,
Gajek
,
J.
,
Hindricks
,
G.
,
Kautzner
,
J.
,
Knuuti
,
J.
,
Kulakowski
,
P.
,
Lambrinou
,
E.
,
Leclercq
,
C.
,
Mabo
,
P.
,
Morillo
,
C. A.
,
Piepoli
,
M. F.
,
Roffi
,
M.
,
Shen
,
W. K.
,
Simpson
,
I. A.
,
Stockburger
,
M.
,
Vanbrabant
,
P.
,
Windecker
,
S.
,
Zamorano
,
J. L.
,
Windecker
,
S.
,
Aboyans
,
V.
,
Agewall
,
S.
,
Barbato
,
E.
,
Bueno
,
H.
,
Coca
,
A.
,
Collet
,
J.-P.
,
Coman
,
I. M.
,
Dean
,
V.
,
Delgado
,
V.
,
Fitzsimons
,
D.
,
Gaemperli
,
O.
,
Hindricks
,
G.
,
Iung
,
B.
,
Jüni
,
P.
,
Katus
,
H. A.
,
Knuuti
,
J.
,
Lancellotti
,
P.
,
Leclercq
,
C.
,
McDonagh
,
T.
,
Piepoli
,
M. F.
,
Ponikowski
,
P.
,
Richter
,
D. J.
,
Roffi
,
M.
,
Shlyakhto
,
E.
,
Sousa-Uva
,
M.
,
Simpson
,
I. A.
,
Zamorano
,
J. L.
,
Roithinger
,
F. X.
,
Chasnoits
,
A.
,
Vandekerckhove
,
Y.
,
Traykov
,
V. B.
,
Puljevic
,
D.
,
Papasavvas
,
E.
,
Kautzner
,
J.
,
Mølgaard
,
H.
,
Nawar
,
M.
,
Parikka
,
H.
,
Vavlukis
,
M.
,
Piot
,
O.
,
Etsadashvili
,
K.
,
Klingenheben
,
T.
,
Deftereos
,
S.
,
Sághy
,
L.
,
Gudmundsson
,
K.
,
Beinart
,
R.
,
Raviele
,
A.
,
Abdrakhmanov
,
A.
,
Mirrakhimov
,
E.
,
Kalejs
,
O.
,
Benlamin
,
H. A.
,
Puodziukynas
,
A.
,
Dimmer
,
C.
,
Sammut
,
M. A.
,
Raducan
,
A.
,
Vukmirović
,
M.
,
Abdelali
,
S.
,
Hemels
,
M. E. W.
,
Haugaa
,
K. H.
,
Baranowski
,
R.
,
Cunha
,
P. S.
,
Dan
,
G.-A.
,
Tyurina
,
T.
,
Bertelli
,
L.
,
Mitro
,
P.
,
Lozano
,
I. F.
,
Bergfeldt
,
L.
,
Osswald
,
S.
,
Afef
,
B. H.
,
Özdemír
,
H. M.
, and
Lim
,
P. B.
,
2018
, “
2018 ESC Guidelines for the Diagnosis and Management of Syncope
,”
Eur. Heart J.
,
39
(
21
), pp.
1883
1948
.
2.
Shen
,
W.-K.
,
Sheldon
,
R. S.
,
Benditt
,
D. G.
,
Cohen
,
M. I.
,
Forman
,
D. E.
,
Goldberger
,
Z. D.
,
Grubb
,
B. P.
,
Hamdan
,
M. H.
,
Krahn
,
A. D.
,
Link
,
M. S.
,
Olshansky
,
B.
,
Raj
,
S. R.
,
Sandhu
,
R. K.
,
Sorajja
,
D.
,
Sun
,
B. C.
, and
Yancy
,
C. W.
,
2017
, “
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
,”
J. Am. Coll. Cardiol.
,
70
(
5
), pp.
e39
e110
.
3.
Probst
,
M. A.
,
Kanzaria
,
H. K.
,
Gbedemah
,
M.
,
Richardson
,
L. D.
, and
Sun
,
B. C.
,
2015
, “
National Trends in Resource Utilization Associated With ED Visits for Syncope
,”
Am. J. Emerg. Med.
,
33
(
8
), pp.
998
1001
.
4.
Thiruganasambandamoorthy
,
V.
,
Taljaard
,
M.
,
Stiell
,
I. G.
,
Sivilotti
,
M. L. A.
,
Murray
,
H.
,
Vaidyanathan
,
A.
,
Rowe
,
B. H.
,
Calder
,
L. A.
,
Lang
,
E.
,
McRae
,
A.
,
Sheldon
,
R.
, and
Wells
,
G. A.
,
2015
, “
Emergency Department Management of Syncope: Need for Standardization and Improved Risk Stratification
,”
Intern. Emerg. Med.
,
10
(
5
), pp.
619
627
.
5.
Reed
,
M. J.
,
Newby
,
D. E.
,
Coull
,
A. J.
,
Prescott
,
R. J.
,
Jacques
,
K. G.
, and
Gray
,
A. J.
,
2010
, “
The ROSE (Risk Stratification of Syncope in the Emergency Department) Study
,”
J. Am. Coll. Cardiol.
,
55
(
8
), pp.
713
721
.
6.
Costantino
,
G.
,
Sun
,
B. C.
,
Barbic
,
F.
,
Bossi
,
I.
,
Casazza
,
G.
,
Dipaola
,
F.
,
McDermott
,
D.
,
Quinn
,
J.
,
Reed
,
M. J.
,
Sheldon
,
R. S.
,
Solbiati
,
M.
,
Thiruganasambandamoorthy
,
V.
,
Beach
,
D.
,
Bodemer
,
N.
,
Brignole
,
M.
,
Casagranda
,
I.
,
Del Rosso
,
A.
,
Duca
,
P.
,
Falavigna
,
G.
,
Grossman
,
S. A.
,
Ippoliti
,
R.
,
Krahn
,
A. D.
,
Montano
,
N.
,
Morillo
,
C. A.
,
Olshansky
,
B.
,
Raj
,
S. R.
,
Ruwald
,
M. H.
,
Sarasin
,
F. P.
,
Shen
,
W.-K.
,
Stiell
,
I.
,
Ungar
,
A.
,
Gert van Dijk
,
J.
,
van Dijk
,
N.
,
Wieling
,
W.
, and
Furlan
,
R.
,
2016
, “
Syncope Clinical Management in the Emergency Department: A Consensus From the First International Workshop on Syncope Risk Stratification in the Emergency Department
,”
Eur. Heart J.
,
37
(
19
), pp.
1493
1498
.
7.
Olmos
,
C.
,
Franco
,
E.
,
Suárez-Barrientos
,
A.
,
Fortuny
,
E.
,
Martín-García
,
A.
,
Viliani
,
D.
,
Macaya
,
C.
, and
de Isla
,
L. P.
,
2014
, “
Wearable Wireless Remote Monitoring System: An Alternative for Prolonged Electrocardiographic Monitoring
,”
Int. J. Cardiol.
,
172
(
1
), pp.
e43
e44
.
8.
Hendrikx
,
T.
,
Rosenqvist
,
M.
,
Wester
,
P.
,
Sandström
,
H.
, and
Hörnsten
,
R.
,
2014
, “
Intermittent Short ECG Recording is More Effective Than 24-Hour Holter ECG in Detection of Arrhythmias
,”
BMC Cardiovasc. Disord.
,
14
, p.
41
.
9.
Subbiah
,
R.
,
Gula
,
L. J.
,
Klein
,
G. J.
,
Skanes
,
A. C.
,
Yee
,
R.
, and
Krahn
,
A. D.
,
2008
, “
Syncope: Review of Monitoring Modalities
,”
Curr. Cardiol. Rev.
,
4
(
1
), pp.
41
48
.
10.
Subbiah
,
R.
,
Chia
,
P.
,
Gula
,
L. J.
,
Klein
,
G. J.
,
Skanes
,
A. C.
,
Yee
,
R.
, and
Krahn
,
A. D.
,
2013
, “
Cardiac Monitoring in Patients With Syncope: Making That Elusive Diagnosis
,”
Curr. Cardiol. Rev.
,
9
(
4
), pp.
299
307
.
11.
Rao
,
A.
,
Lomax
,
S.
, and
Ramsdale
,
K. R. D.
,
2007
, “
Ambulatory Cardiac Rhythm Monitoring
,”
Br. J. Hosp. Med.
,
68
(
3
), pp.
132
138
.
12.
Locati
,
E. T.
,
Moya
,
A.
,
Oliveira
,
M.
,
Tanner
,
H.
,
Willems
,
R.
,
Lunati
,
M.
, and
Brignole
,
M.
,
2016
, “
External Prolonged Electrocardiogram Monitoring in Unexplained Syncope and Palpitations: Results of the SYNARR-Flash Study
,”
Europace
,
18
(
8
), pp.
1265
1272
.
13.
Krahn
,
A. D.
,
Andrade
,
J. G.
, and
Deyell
,
M. W.
,
2013
, “
Selecting Appropriate Diagnostic Tools for Evaluating the Patient With Syncope/Collapse
,”
Prog. Cardiovasc. Dis.
,
55
(
4
), pp.
402
409
.
14.
Locati
,
E. T.
,
Vecchi
,
A. M.
,
Vargiu
,
S.
,
Cattafi
,
G.
, and
Lunati
,
M.
,
2014
, “
Role of Extended External Loop Recorders for the Diagnosis of Unexplained Syncope, Pre-Syncope, and Sustained Palpitations
,”
Europace
,
16
(
6
), pp.
914
922
.
15.
Costantino
,
G.
,
Solbiati
,
M.
,
Casazza
,
G.
,
Bonzi
,
M.
,
Vago
,
T.
,
Montano
,
N.
,
McDermott
,
D.
,
Quinn
,
J.
, and
Furlan
,
R.
,
2014
, “
Usefulness of N-Terminal Pro-B-Type Natriuretic Peptide Increase as a Marker for Cardiac Arrhythmia in Patients With Syncope
,”
Am. J. Cardiol.
,
113
(
1
), pp.
98
102
.
16.
Solbiati
,
M.
, and
Sheldon
,
R. S.
,
2014
, “
Implantable Rhythm Devices in the Management of Vasovagal Syncope
,”
Auton. Neurosci.
,
184
, pp.
33
39
.
17.
Solbiati
,
M.
,
Casazza
,
G.
,
Dipaola
,
F.
,
Barbic
,
F.
,
Caldato
,
M.
,
Montano
,
N.
,
Furlan
,
R.
,
Sheldon
,
R. S.
, and
Costantino
,
G.
,
2017
, “
The Diagnostic Yield of Implantable Loop Recorders in Unexplained Syncope: A Systematic Review and Meta-Analysis
,”
Int. J. Cardiol.
,
231
, pp.
170
176
.
You do not currently have access to this content.