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Cardiac arrhythmia means that the heartbeat is erratic, too fast, or too slow. An arrhythmia can increase the risk of stroke, heart attack, or sudden cardiac death. To diagnose the specific problem, doctors often initially use an electrocardiograph (ECG). Patients whose symptoms occur too infrequently to be detected by this test in the hospital may be asked to wear a device called an ambulatory ECG monitor for several days or weeks while at home.

Our review looked at two types of devices used for long-term ECG monitoring. They are equally effective at detecting arrhythmia based on a patient’s symptoms. Combined, about 85,000 of these two types of tests were done in Ontario in 2014. In recent years, use of one type, called long-term continuous ambulatory ECG monitors, has grown steadily in this province. At the same time, use of the other type, called external cardiac loop recorders, has decreased but still accounts for about half of these tests.

Doing ambulatory ECG tests by long-term continuous monitor currently costs the health care system somewhat more but has advantages over external cardiac loop recorders. The long- term continuous monitors can record for longer periods, store more information about the heartbeat, and are often easier for patients to use.