Comparing the Quality of Home and Clinic Applied Zio XT Patch in Pediatrics During the Pandemic

Background: The Zio® (Zio) XT Patch (iRhythm Technologies, Inc, San Francisco, California) is a 14-day continuous ambulatory ECG monitor. During the Covid-19 Pandemic, Zios were shipped directly to patients for self-application. The purpose of this study was to compare the quality of in-clinic (IC) to mail-home (MH) in our pediatric population.

Methods: A single-center, IRB-approved study (1/1/18 – 6/1/21) of patients < 21 years of age with Zios were studied for wear and artifact time filtered out based on iRhythm’s inherent algorithm. A control group of patients were age-matched from Zios placed IC and compared to MH Zios throughout the pandemic.

Results: A total of 284 Zios were analyzed for total wear time and artifact filtered out. Of these, 149 were IC, and 135 were MH. Average percent of artifact of IC vs MH was 7.1% and 8.3% (p = 0.58). The average age of patients with Zios placed in clinic was older (12.84 years) than those placed at home (11.12 years, p<0.02). There was no significant difference in artifact when adjusted for age. Age was inversely associated with percent artifact with a 0.34% reduction in percent artifact for every additional year of age (p < 0.049). Location was not associated with percent artifact after controlling for age. By two proportion Z-test, there was no statistically significant difference between IC and MH Zios wasted (p = 0.66) or repeated (p = 0.96).

Conclusion: In conclusion, IC and MH Zios did not demonstrate any significant difference in artifact time filtered out. This highlights the potential for home application during current pandemic and future telemedicine utilization.