• The technology described in this briefing is the Zio Service. It is a remote cardiac monitoring system used for detecting cardiac arrhythmias.

  • The innovative aspects are that this device can collect continuous cardiac monitoring data for up to 14 days through an adhesive biosensor patch (the Zio Patch). At the end of the monitoring period, the user posts the Zio Patch to the manufacturer, who produces a report for clinicians (the Zio Report). The Zio Patch is non-invasive, water resistant and has no leads or wires so people may find it easier to wear than other ambulatory monitors.

  • The intended place in therapy would be instead of current methods of cardiac event detection, such as Holter monitoring or event recording in people suspected of having cardiac arrhythmias.

  • The main points from the evidence summarised in this briefing are from 6 studies based outside the UK: 2 comparative studies (n=220), 2 non-comparative prospective studies (n=249) and 2 large non-comparative retrospective studies (n=149,205) on adult patients in a home setting. Of the 2 comparative studies, 1 reported that the Zio Service detected more arrhythmia events than Holter monitoring in the first 24 hours and the other reported excellent agreement between the 2 methods. Both studies found that using the Zio Service over 14 days detected more arrhythmia events than Holter monitoring over 24 hours.

  • Key uncertainties around the evidence or technology include that there is no evidence comparing the Zio Service with other monitoring devices that have a similar monitoring period.

  • The list price of the Zio Service is around £800 per unit (exclusive of VAT). This includes the patch, the data analysis and the report. The resource impact would be increased monitoring costs compared with 24‑hour Holter monitoring, but this could be offset if Zio Patch were shown to increase early and correct diagnoses and reduce repeat monitoring and admissions.