Table 3: Main Characteristics of Different Cardiac Monitoring Devices.
| Holter monitoring | Post-event recorders | External loop recorders (ELRs)/mobile cardiac output telemetry | Implantable loop recorders | |
| Advantages | -Low cost; continuous monitoring | -Duration of monitoring up to 1 month - The device does not need to be worn 24 hours - Remote monitoring possible | - Automatic detection of asymptomatic arrhythmias, ECG recording before and after arrhythmia onset - Possibility of real-time continuous monitoring with MCOT - Duration of monitoring up to 1 month - Remote monitoring possible | - The same as ELRs - Duration of monitoring up to 3 years - No need for patient collaboration - Remote monitoring possible |
| Limits | - Short duration of monitoring (generally 24–48 hours; no more than 2 weeks) - Compliant patients | - Intermediate cost - Non-continuous monitoring - Does not register asymptomatic arrhythmias and heart rhythm during disabling symptoms that prevent patients activating the device - ECG storage limits - Compliant patients | - Intermediate cost - ECG storage limits for ELRs - Compliant patients | - High cost - Minimally invasive surgery for implantation - Non-continuous monitoring - ECG storage limits |
| Indications | - Initial evaluation of patients with syncope, palpitations and frequently recurring symptoms (≤1 week) - 2-week Holter monitoring in cryptogenic stroke to underline AF - 24–48-hour Holter for monitoring the efficacy of rate control therapy in AF patients | - Infrequent palpitations (≤1 month) not accompanied by disabling symptoms | - Palpitations or syncope with ≤1 month inter-symptom intervals - Patients with cryptogenic stroke to underline AF | - Infrequent syncope or palpitations in patients with suspected arrhythmias and >1 month inter-symptom intervals - Patients with cryptogenic stroke and high suspicion of AF despite negative evaluation with 2-week Holter monitoring or ELR/mobile cardiac output telemetry - Monitoring of patients who have undergone transcatheter ablation for AF |
AF: atrial fibrillation. Modified from Giada et al., 2012[3]