Extended Wearable ECG Monitoring Detects Unrecognised Arrhythmias After COPD Exacerbation: The PRECURSOR Pilot Study.
5 affiliations
- 1Department of Respiratory Medicine, University General Hospital of Larissa, University of Thessaly, Larissa, Greece.
- 2Department of Physiology, Faculty of Medicine, University of Thessaly, Larissa, Greece.
- 3MOKAAL Information Technology Company, Ioannina, Greece.
- 4Department of Nursing, University of Thessaly, Larissa, Greece.
- 5Department of Respiratory Medicine, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece.
Abstract
Background
The period after hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with cardiovascular vulnerability. Clinically important rhythm disturbances may be intermittent or asymptomatic and escape routine postdischarge assessment; however, the diagnostic yield of prolonged monitoring is intrinsically influenced by monitoring duration.Methods
In this prospective, single-centre observational pilot, 18 adults recently hospitalised for COPD exacerbation underwent continuous remote monitoring for 21 days between September 2019 and February 2020. The three-lead ZENSOR wearable recorded electrocardiographic rhythm, heart rate and respiratory rate and transmitted full-disclosure data and predefined alerts for clinician review. The primary outcome was participant-level detection of previously unrecognised, cardiologist-confirmed arrhythmias warranting therapeutic evaluation or intervention. Outcomes were analysed descriptively with exact 95% binomial confidence intervals.Results
Participants were predominantly male (15/18; 83.3%), with a mean age of 73 ± 6 years. Seven had GOLD grade 3-4 airflow limitation, seven received long-term oxygen therapy, five had coronary artery disease and four had chronic atrial fibrillation. During the planned 21-day monitoring period, previously unrecognized clinically actionable arrhythmias were detected in 9/18 participants (50.0%; 95% CI: 26.0-74.0). Nonmutually exclusive findings included trigeminy (2/18), third-degree atrioventricular block (2/18), bradycardia (5/18), newly detected atrial fibrillation (1/18), supraventricular tachycardia (2/18) and nocturnal atrial or ventricular ectopy (8/18). Sixteen participants (88.9%; 95% CI: 65.3-98.6) reported satisfaction with monitoring.Conclusions
Extended wearable electrocardiographic monitoring produced a high participant-level detection yield of previously unrecognised arrhythmias during early recovery from hospitalised COPD exacerbation. This finding supports targeted postdischarge rhythm surveillance but does not distinguish biological post-exacerbation vulnerability from the greater ascertainment achieved by prolonged monitoring. Confirmation requires larger controlled studies with comprehensive cardiopulmonary phenotyping, standardised monitoring-performance metrics and comparative clinical outcomes.
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BibTeX
@article{kotsiou2026extended,
title = {{Extended Wearable ECG Monitoring Detects Unrecognised Arrhythmias After COPD Exacerbation: The PRECURSOR Pilot Study.}},
author = {Ourania S Kotsiou and Eudoxia Gogou and Dimitra Siachpazidou and Maria Pinaka and Fotini Bardaka and Antonios Garyfallos and Dimitrios Mantzaris and Alexandros Garyfallos and Athanasios Konstantinidis and Konstantinos I Gourgoulianis},
journal = {The clinical respiratory journal},
year = {2026},
month = nov,
doi = {10.1111/crj.70240},
url = {https://europepmc.org/article/MED/42969162},
note = {CC BY},
}
RIS
TY - JOUR
TI - Extended Wearable ECG Monitoring Detects Unrecognised Arrhythmias After COPD Exacerbation: The PRECURSOR Pilot Study.
AU - Ourania S Kotsiou
AU - Eudoxia Gogou
AU - Dimitra Siachpazidou
AU - Maria Pinaka
AU - Fotini Bardaka
AU - Antonios Garyfallos
AU - Dimitrios Mantzaris
AU - Alexandros Garyfallos
AU - Athanasios Konstantinidis
AU - Konstantinos I Gourgoulianis
PY - 2026
DA - 2026/11/01
JO - The clinical respiratory journal
DO - 10.1111/crj.70240
UR - https://europepmc.org/article/MED/42969162
AB - Background The period after hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with cardiovascular vulnerability. Clinically important rhythm disturbances may be intermittent or asymptomatic and escape routine postdischarge assessment; however, the diagnostic yield of prolonged monitoring is intrinsically influenced by monitoring duration.Methods In this prospective, single-centre observational pilot, 18 adults recently hospitalised for COPD exacerbation underwent continuous remote monitoring for 21 days between September 2019 and February 2020. The three-lead ZENSOR wearable recorded electrocardiographic rhythm, heart rate and respiratory rate and transmitted full-disclosure data and predefined alerts for clinician review. The primary outcome was participant-level detection of previously unrecognised, cardiologist-confirmed arrhythmias warranting therapeutic evaluation or intervention. Outcomes were analysed descriptively with exact 95% binomial confidence intervals.Results Participants were predominantly male (15/18; 83.3%), with a mean age of 73 ± 6 years. Seven had GOLD grade 3-4 airflow limitation, seven received long-term oxygen therapy, five had coronary artery disease and four had chronic atrial fibrillation. During the planned 21-day monitoring period, previously unrecognized clinically actionable arrhythmias were detected in 9/18 participants (50.0%; 95% CI: 26.0-74.0). Nonmutually exclusive findings included trigeminy (2/18), third-degree atrioventricular block (2/18), bradycardia (5/18), newly detected atrial fibrillation (1/18), supraventricular tachycardia (2/18) and nocturnal atrial or ventricular ectopy (8/18). Sixteen participants (88.9%; 95% CI: 65.3-98.6) reported satisfaction with monitoring.Conclusions Extended wearable electrocardiographic monitoring produced a high participant-level detection yield of previously unrecognised arrhythmias during early recovery from hospitalised COPD exacerbation. This finding supports targeted postdischarge rhythm surveillance but does not distinguish biological post-exacerbation vulnerability from the greater ascertainment achieved by prolonged monitoring. Confirmation requires larger controlled studies with comprehensive cardiopulmonary phenotyping, standardised monitoring-performance metrics and comparative clinical outcomes.
SN - 1752-6981
SN - 1752-699X
ER -