EXTENDED wearable electrocardiographic monitoring detected previously unrecognised, clinically actionable arrhythmias in half of patients recovering from hospitalisation for a COPD exacerbation, a small pilot study reports.

The PRECURSOR study suggests that rhythm disturbances may go undetected during routine follow-up. However, its observational design cannot establish whether the findings reflect increased vulnerability after an exacerbation or simply the greater opportunity to detect abnormalities through prolonged monitoring.

Monitoring Recovery at Home

The prospective, single-centre study enrolled 18 adults following hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease. Participants underwent continuous remote monitoring for a planned 21 days.

A three-lead wearable device recorded electrocardiographic rhythm, heart rate and respiratory rate, transmitting information and predefined alerts for clinical review.

Participants had a mean age of 73 years, and 15 were men. Several had substantial respiratory disease or existing cardiovascular conditions, making this a clinically complex group rather than a representative sample of everyone living with COPD.

Arrhythmias Identified in Half

Previously unrecognised arrhythmias warranting therapeutic evaluation or intervention were confirmed by a cardiologist in nine participants. This represented 50.0% of the cohort, with a wide 95% confidence interval of 26.0–74.0%.

Detected abnormalities included bradycardia, third-degree atrioventricular block, newly identified atrial fibrillation and supraventricular tachycardia. Some participants had more than one finding.

Sixteen participants reported satisfaction with monitoring, suggesting that extended surveillance was acceptable to most people in this small study. Nevertheless, satisfaction does not establish clinical effectiveness or demonstrate that a monitoring programme would be practical at scale.

Detection Versus Better Outcomes

The central finding concerns detection. The study does not demonstrate that wearable monitoring reduces hospital readmissions, prevents cardiovascular events or improves survival.

Without a comparison group undergoing an equivalent monitoring period, it is also difficult to determine how much of the detection yield relates specifically to recent exacerbation.

The small sample means that individual findings substantially affect the overall percentage. Larger studies would provide more precise estimates and help establish which patients are most likely to benefit.

The results offer a rationale for investigating targeted rhythm surveillance during recovery from a COPD admission. Future research should compare monitoring strategies, document resulting treatment decisions and assess whether identifying additional arrhythmias produces meaningful improvements in patient outcomes. Until then, the findings support further evaluation rather than universal monitoring after every COPD exacerbation.

Reference

Kotsiou OS et al. Extended wearable ECG monitoring detects unrecognised arrhythmias after COPD exacerbation: the PRECURSOR pilot study. Clin Respir J. 2026;20(11):e70240. doi:10.1111/crj.70240.