Trial reportEuropean journal of medical research2019
Early prolonged ambulatory cardiac monitoring in stroke (EPACS): an open-label randomised controlled trial.
Trial report in European journal of medical research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Impact of Mobile Health Devices for the Detection of Atrial Fibrillation: Systematic Review.JMIR mHealth and uHealth · 2021Pooled it
- Digital Phenotyping in Health Research: Scoping Review of Methods, Gaps, and Opportunities.Journal of medical Internet research · 2026Article
- Wearable Devices and Machine Learning in Cardiovascular Monitoring: Current Evidence and Future Directions for Precision Medicine.Journal of personalized medicine · 2026Review
- Wearable Technology in Cardiology: Advancements, Applications, and Future Prospects.Reviews in cardiovascular medicine · 2025Review
- Wearable Devices for Arrhythmia Detection: Advancements and Clinical Implications.Sensors (Basel, Switzerland) · 2025Review
- Intersecting Pathways: The Role of Metabolic Dysregulation, Gastrointestinal Microbiome, and Inflammation in Acute Ischemic Stroke Pathogenesis and Outcomes.Journal of clinical medicine · 2024Review
- Handheld 6-Lead ECG for Early Detection of Acute Inferior Wall ST-T Segment Elevation Myocardial Infarction: HINT-MI Study Design and Rationale.Medicina (Kaunas, Lithuania) · 2024Observational
- The Usefulness of Outpatient Cardiac Telemetry in Patients with Cryptogenic Stroke.Journal of clinical medicine · 2024Article
- A Patient-Centered Approach to Cardiac Monitoring After Cryptogenic Stroke: A Review.Stroke (Hoboken, N.J.) · 2024Review
- Cost-Minimization Model in Cryptogenic Stroke: ePatch vs Implantable Loop Recorder in Patients from the UK, Netherlands, and Sweden.Medical devices (Auckland, N.Z.) · 2024Article
- Validation of a Deep Learning Algorithm for Continuous, Real-Time Detection of Atrial Fibrillation Using a Wrist-Worn Device in an Ambulatory Environment.Journal of the American Heart Association · 2023Observational
- The Impact of Heart Rate Variability Monitoring on Preventing Severe Cardiovascular Events.Diagnostics (Basel, Switzerland) · 2023Review
- Wearables in Cardiovascular Disease.Journal of cardiovascular translational research · 2023Review
- Wearable Devices in Cardiovascular Medicine.Circulation research · 2023Review
- Searching for atrial fibrillation post stroke: is it time for digital devices?Frontiers in cardiovascular medicine · 2023Review
- European Stroke Organisation (ESO) guideline on screening for subclinical atrial fibrillation after stroke or transient ischaemic attack of undetermined origin.European stroke journal · 2022Article
- Systemic immune inflammation index and system inflammation response index are potential biomarkers of atrial fibrillation among the patients presenting with ischemic stroke.European journal of medical research · 2022Article
- Improving stroke pathways using an adhesive ambulatory ECG patch: reducing time for patients to ECGs and subsequent results.Future healthcare journal · 2022Article
- The Impact of Wearable Technologies in Health Research: Scoping Review.JMIR mHealth and uHealth · 2022Article
- Remote Cardiac Rhythm Monitoring in the Era of Smart Wearables: Present Assets and Future Perspectives.Frontiers in cardiovascular medicine · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCardioembolism in paroxysmal atrial fibrillation (PAF) is a preventable cause of transient ischaemic attack (TIA) or ischaemic stroke; however, due to its transient nature, a short-duration Holter monitor may miss a significant proportion of events.
methodsWe conducted an open-label randomised controlled trial of cardiac monitoring after a TIA or ischaemic stroke comparing a 14-day ECG monitoring patch (Zio
resultsFrom February 2016 through February 2017, 43 (76.8%) of the 56 patients assigned to the patch-based monitoring group and 47 (78.3%) of the 60 patients assigned to short-duration Holter monitoring group had successful monitor placement with 90 days of follow-up. Of the 26 protocol failures between the two groups, 23 (88.5%) were due to patient refusal for outpatient short-duration ECG monitor placement, whilst only 1 (3.8%) was due unsuccessful ZioPatch placement. The rate of detection of PAF at 90 days was 16.3% in the patch-based monitoring group (seven patients) compared to 2.1% in the short-duration Holter monitoring group (1 patient), with an odds ratio of 8.9 (95% CI 1.1-76.0; P = 0.026). An economic model demonstrated that implementation of the Zio Patch service would result in 10.8 more strokes avoided per year compared to current practice with Holter monitoring with an associated yearly saving in direct medical costs of £113,630, increasing to £162,491 over 5 years.
conclusionsEarly, prolonged, patch-based monitoring after an index stroke or TIA is superior to short-duration Holter monitoring in the detection of PAF and likely cost-effective for preventing recurrent strokes. Trial registration http://www.isrctn.com. Unique identifier: ISRCTN 50253271. Registered 21 January 2016.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.