Arrhythmias & electrophysiology
Relationship of symptom frequency and symptom-rhythm correlation to arrhythmia type and time to detection: Insights from ambulatory electrocardiogram monitoring in over 1 million patients
Authors' conclusion
Symptom-rhythm correlation varied by arrhythmia type and symptom frequency. The median time to actionable arrhythmia was >48 hours, regardless of symptom frequency. Holter may miss clinically meaningful events, even in patients with daily symptoms.
Study context
- Population
- Adults ≥18 years with uninterrupted patch-based long-term continuous monitoring (≤14 days) with push-button symptom annotation, June 2023–July 2024
- Participants
- 1,100,337 devices
- Exposure
- Daily vs nondaily symptoms during long-term continuous monitoring
- Outcome
- Arrhythmia yield, time to first arrhythmia and symptom-rhythm correlation
Main finding
As reported in the abstract
Arrhythmia yield and time to first arrhythmia by symptom frequency
Arrhythmias occurring after 48 hours
| Outcome | Daily | Nondaily |
|---|---|---|
| Median time to detection | 3.52 days (Q1-Q3 0.94-7.45) | 3.00 (0.72-6.97) |
- Adjusted odds of arrhythmia yield did not differ by symptom frequency
- adjusted OR 1.00 (95% CI 0.98-1.02)
- Actionable arrhythmia yield (overall)
- 35.8%
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted OR (95% CI) | |
|---|---|---|
| Symptom-rhythm correlation | 0.226 (0.223–0.229) | |
| 0.20.5125Adjusted odds ratio (log scale) |
- Symptom-rhythm correlation — Overall
- 18.3%
- Symptom-rhythm correlation — AF and isolated ectopic beats
- >30%
- Symptom-rhythm correlation — Other rhythms
- <15%
Original publication
Relationship of symptom frequency and symptom-rhythm correlation to arrhythmia type and time to detection: Insights from ambulatory electrocardiogram monitoring in over 1 million patients. Heart Rhythm. Published 7 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it