CONGRESS ABSTRACT

Introduction: Atrial fibrillation (AF) is one of the most common arrhythmias and its diagnosis is often challenging yet crucial for therapeutic, prognostic, and quality-of-life considerations. Event recorders may offer an efficient solution for diagnosing AF or other arrhythmias in patients with paroxysmal palpitations. We tested a 6-lead event recorder (Kardia6L) for diagnosing arrhythmias in symptomatic patients presenting with palpitations. Materials and Methods: This prospective study was conducted at Santa Maria Nuova Hospital (Florence, Italy). Thirty-seven patients were enrolled between January and November 2024. All patients underwent cardiology consultation for paroxysmal palpitations, including a 12-lead ECG and resting echocardiography. Each patient received a Kardia6L device for a 30-day period, along with instructions to download the accompanying smartphone app. The primary endpoint was the diagnosis of AF. Upon experiencing palpitations, patients used the Kardia6L to record a 6-lead ECG by placing their fingers on the device. In case of detected abnormalities, the ECG trace was automatically emailed to the referring cardiologist. Results: Thirty-seven patients were included, with a mean age of 59±10 years; 21 were female (56%). The mean CHA2DS2-VA score was 0.9±1. AF was newly diagnosed in 3 patients, while 2 additional cases of supraventricular tachycardia (SVT) were identified. Two AF patients began anticoagulant therapy, while the third patient (CHA2DS2-VA 0) was referred for ablation. Discussion: Palpitations are debilitating symptoms that may be associated with AF. Capturing arrhythmias via standard ECG can be challenging when symptoms are paroxysmal. Holter monitoring and loop recorders, often prescribed in such cases, may fail to detect arrhythmias. Kardia6L devices offer a practical and effective solution as they allow ECG recording at the moment of symptoms, unlike Holter monitoring. Studies also suggest that patients prefer long-term intermittent monitoring with Kardia6L instead of short continuous Holter monitoring. This method is particularly advantageous for younger individuals, minimizing work absences, and is more cost-effective for healthcare systems. Conclusions: Diagnosing AF in symptomatic patients with paroxysmal palpitations can be challenging. We propose that Kardia6L devices represent a practical, cost-effective, and efficient solution.