iRhythm Technologies’ Zio long-term continuous monitoring (LTCM) service has been shown to enhance atrial fibrillation (AFib) detection in the AMALFI clinical trial.
AMALFI, which expands to Active Monitoring for AtriaL Fibrillation, is a randomised clinical trial. It assessed the efficacy of home-based long-term ECG monitoring in identifying Afib compared to usual care, over 2.5 years.
The trial was led by Oxford University as an entirely remote study, with devices mailed to participants, involving no physical study sites or in-person visits.
It enrolled 5,040 UK participants, aged 65 and above, who are at moderate to high stroke risk.
In the AMALFI trial, participants used the Zio XT LTCM device for up to 14 days.
The study results revealed that the Zio LTCM service significantly accelerates AFib diagnosis compared to traditional care methods.
The findings were presented at the European Society of Cardiology Congress 2025 and published in the Journal of the American Medical Association.
Oxford Population Health medicine and clinical trials professor and co-author of the study Louise Bowman said: “Atrial fibrillation can be difficult to detect as it often occurs without symptoms or infrequently.
“New technology enables home-based, longer-duration monitoring that can identify episodes which might otherwise be missed.
“AMALFI showed that home-based monitoring is feasible and provides evidence that it can be initiated at scale using primary care health records with minimal burden on patients and practices.”
The study aligns with the UK’s National Health Service’s strategy to focus on early disease detection and prevention in primary care settings.
The Zio service, available in the UK since 2014, uses a wearable sensor to monitor heart rhythms continuously for up to 14 days, providing a comprehensive analysis of arrhythmias.
Data is processed through a UKCA-marked algorithm, offering a streamlined approach for patients to apply and use the device at home without clinic visits.
Funded by the National Institute for Health and Care Research and the British Heart Foundation, the AMALFI trial supplements iRhythm’s clinical evidence portfolio.
iRhythm supported the trial by providing the Zio LTCM service free of charge.
iRhythm chief medical and scientific officer, advanced technologies executive vice president Mintu Turakhia said: “The AMALFI results show that home-based, long-term continuous monitoring with Zio can improve the timely detection and diagnosis of atrial fibrillation.
“These findings add to the growing evidence that population health approaches to identify undiagnosed arrhythmias can be implemented at scale, demonstrated here through primary care in the UK, and can enable prompt therapy such as anticoagulation, rate and rhythm control, and cardiovascular risk factor reduction.”
