Extended wearable ECG monitoring for 21 days after hospitalisation for COPD exacerbation detected previously unrecognised, clinically actionable arrhythmias in 9 of 18 participants (50%), supporting targeted postdischarge rhythm surveillance, although the design cannot separate true post-exacerbation vulnerability from the greater ascertainment achieved by prolonged monitoring.
Key Findings
Results
Half of participants had previously unrecognised, cardiologist-confirmed, clinically actionable arrhythmias during 21 days of wearable monitoring after a COPD exacerbation hospitalisation.
Primary outcome: detection in 9/18 participants (50.0%; 95% CI: 26.0-74.0).
Prospective, single-centre observational pilot with continuous remote monitoring for 21 days, conducted between September 2019 and February 2020.
Outcomes were analysed descriptively with exact 95% binomial confidence intervals.
The confidence interval is wide because of the small sample.
Results
A range of arrhythmia types and conduction abnormalities was detected, with nocturnal atrial or ventricular ectopy and bradycardia being the most frequent.
Nocturnal atrial or ventricular ectopy: 8/18; bradycardia: 5/18.
The three-lead ZENSOR wearable recorded ECG rhythm, heart rate and respiratory rate and transmitted full-disclosure data and predefined alerts for clinician review.
Conclusions
The study design cannot distinguish biological post-exacerbation cardiac vulnerability from higher detection due to prolonged monitoring.
The authors state the finding 'does not distinguish biological post-exacerbation vulnerability from the greater ascertainment achieved by prolonged monitoring.'
There was no control group, and the sample was small and from a single centre.
Confirmation requires larger controlled studies with comprehensive cardiopulmonary phenotyping, standardised monitoring-performance metrics and comparative clinical outcomes.
What This Means
This small pilot study followed 18 older adults, mostly men, who had just been in hospital for a flare-up of chronic obstructive pulmonary disease (COPD). For 21 days after leaving hospital they wore a small device that continuously recorded their heart rhythm, heart rate and breathing rate and sent the data to clinicians. Cardiologists reviewed the recordings for rhythm problems that had not been known before and that needed treatment or further evaluation.
Such previously unrecognised rhythm problems were found in 9 of the 18 people (50%). Because the group was so small, the true rate could plausibly lie anywhere from about 26% to 74%. Problems included extra heartbeats at night (8 people), slow heart rates (5), serious heart block (2), trigeminy, a fast rhythm called supraventricular tachycardia (2 each), and newly found atrial fibrillation (1). Most participants (16 of 18) said they were satisfied with wearing the device.
This research suggests that longer heart-rhythm monitoring after a COPD hospital stay may reveal hidden problems that routine follow-up could miss. However, the study had no comparison group, so it cannot show whether these rhythm problems are truly more common after a COPD flare-up or are simply found more often when people are monitored for longer. Larger, controlled studies are needed to confirm the findings and to show whether detecting these problems improves patient outcomes.
Kotsiou O, Gogou E, Siachpazidou D, Pinaka M, Bardaka F, Garyfallos A, et al.. (2026). Extended Wearable ECG Monitoring Detects Unrecognised Arrhythmias After COPD Exacerbation: The PRECURSOR Pilot Study.. The clinical respiratory journal. https://doi.org/10.1111/crj.70240