1 Recommendations

1.1 Zio XT shows promise for detecting cardiac arrythmias. However, there is not enough evidence on its diagnostic accuracy compared with standard care to support the case for routine adoption in the NHS.

1.2 Research is recommended to address uncertainties about the diagnostic accuracy and resource use associated with Zio XT compared with standard care. This research should determine the:

  • relative diagnostic accuracy of Zio XT for detecting various types of arrhythmia compared with continuous ECG monitoring used as standard care in the NHS.

  • resource use associated with Zio XT monitoring compared with standard care, in particular the number of outpatient visits and repeat tests needed.

Why the committee made these recommendations

Zio XT is a remote electrocardiogram (ECG) monitoring service used to detect cardiac arrhythmias. The service comprises a wearable single-lead ECG device, software that analyses ECG data, and a technical report.

Clinical evidence suggests that Zio XT may be more acceptable to people than current standard care in the NHS, so they're more likely to wear it for longer. It may also improve diagnostic yield (how many people are diagnosed with cardiac arrhythmia using Zio XT) compared with standard care. However, there is little published evidence investigating its relative diagnostic accuracy (the ability of the test to correctly identify people with the condition) compared with standard care over comparable time periods. This means it is not clear if changes to treatment are an appropriate response to the patient's condition.

There is also little evidence to show its likely effect on resource use in the NHS.

Therefore further research is recommended.