Cardiac arrhythmias are undiagnosed because of their frequent transient and asymptomatic characteristic. This observational study on 167 patients assesses diagnosis and therapeutic advantages of electrocardiogram (ECG) remote monitoring on an at-risk population living in rural areas. Patients referred for ECG ambulatory monitoring were put on continuous recording to detect cardiac arrhythmias.

A total of 167 patients referred for evaluation of cardiac arrhythmia underwent simultaneous ECG ambulatory recording with a Holter monitor. Arrhythmias were automatically detected and the tracings transmitted by phone to a secure server for heart rate (HR) analysis. This study main objective was to evaluate the detection of 6 different kinds of arrhythmias including supraventricular tachycardia, atrial fibrillation (AF)/flutter, pause longer than 3seconds atrioventricular block, ventricular tachycardia or inappropriate sinusal tachycardia.

One hundred and sixty-seven patients with sinus rhythm. Thirty-nine percent men and 61% women, mean age of 64-years-old. Nine percent had already experienced a stroke and 7% suffered coronary disease. Thirty-five percent were taking an anti-arrythmic and 17% were taking anticoagulant. CHADS2Vasc2=2. Monitoring lasted 11days, 11hours per day, 248 ECG were transmitted. Recorded changes are:

– absence of abnormality (44%);

– onset of AF (31%);

– discovery of regular sinusal tachycardia (25%) treated with heart rate control medications.

Screening and early detection of AF is one of the strategy main priorities to optimise anti-arrhythmia and anticoagulant treatment in real time. Early results show that 4 patients have an indication of implant placement and 3 for radiofrequency ablation. Both system and method are a quick and interesting solution to data transfer between medical experts and local family practitioners in order to take the most appropriate decisions.

A long-term single-lead monitoring in detection of arrhythmia events on referred patients for ECG ambulatory monitoring is a simple method. The quality of life of rural population and retired people who require medical attention without moving could be significantly improved in term of diagnosis, treatment and drug prescriptions to prevent stroke.