Understanding patient preferences, experiences and engagement with ambulatory heart rhythm monitoring: a scoping review

OBJECTIVE: To review the literature reporting patient preferences for ambulatory heart rhythm monitoring (AHRM) and what factors affect experience and engagement. BACKGROUND: The prevalence of arrhythmia continues to rise and contributes significantly to outpatient care burden. There is limited understanding of patient experience and compliance with monitoring. As innovative technologies are developed and healthcare strategies move towards surveillance and prevention, understanding this is key. METHODS: A scoping review was conducted using guidance from the Joanna Briggs Institute and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The review included studies of adults under investigation or surveillance for arrhythmia with a range of devices (Holter monitor, patch device, event recorder, mobile cardiac telemetry, external and implantable loop recorders, wearables and other implantable cardiac devices) in ambulatory care settings worldwide. The final search was conducted on 3 January 2026 across Medline (PubMed), Embase (Ovid), Web of Science (Clarivate Analytics), Cumulative Index to Nursing and Allied Health Literature (EBSCOhost), PsycINFO (Ovid) and Google Scholar. Quantitative, qualitative, mixed methods, multiple methods and any type of review articles were included. RESULTS: 54 studies were eligible for inclusion from the initial search that identified 1320 articles. Two overarching themes emerged from the quantitative and qualitative data: patient factors and device factors affecting experience and engagement. Patient factors included clinical and demographic factors, education and expectations, experience and preferences and impact on daily life and healthcare. Device factors could be common to several devices, for example, skin irritation or device specific, for example, the nature of activation. CONCLUSION: Patient and device factors influence preferences for and experience and engagement with AHRM. While existing literature is incomplete and heterogeneous, it identifies key considerations that should be integrated into the development and testing of novel approaches for arrhythmia surveillance in healthcare contexts. REGISTRATION: https://doi.org/10.17605/OSF.IO/6K3W8 (Open Science Framework).