Unlike Zio and Piix which are both single-lead monitors, the V-Patch monitor from a company based in Australia provides a three-lead tracing. While the design is larger than that of the Zio or Piix, it does shed most of the wires of traditional Holters and event monitors. It’s also waterproof. Similar to to the Piix patch, data is transmitted wirelessly via a cellular-enabled controller unit. The V-Patch can be worn for up to 7-days at a time. Currently, the V-Patch is not available in the United States though it has received 510(k) clearance.
The common feature among these devices is their design. All place a premium on low-profile design to help drive compliance with prolonged monitoring. To be fair, these device are not without their issues. For example, they rely on adhesives to stick the skin, which carries obvious challenges. And while they do attempt to embrace connectivity, both the V-Patch and Piix require a separate unit to collect and transmit the data even if that entire process is wireless. However, the price point here may make those weaknesses far more palatable – the Zio patch runs about $500.
The gap between detection and benefit
With any screening modality, both the accuracy of the technique and reaching as many appropriate patients is critical to making a meaningful positive impact on health. These devices can help lower the cost of screening, increase the penetration of screening programs, and improve compliance with the screening it help. The benefits, however, rest in the systems built around these screening programs to help shorten the loop from detection to intervention. The value of detecting atrial fibrillation is lost if patients aren’t started on anticoagulation and other appropriate therapies.
There are a variety of strategies that could be employed to help achieve that benefit. For example, trying to focus screening efforts on patients who are eligible for anticoagulation could help simplify the process of initiating therapy after detection. Similarly pairing screening with multi-modality educational material to help patients understand atrial fibrillation and the associated risks/benefits of therapy could allow patients in whom atrial fibrillation is detected to make informed decisions more expeditiously about starting anticoagulant therapy.
So while there is a great deal of hype around many of these devices, much work remains to be done to help realize the promise they hold.