Hativ® ELectrocardiogram Monitoring on Patients With Suspected Arrhythmia (HELP-A)

September 1, 2026 updated by: Young Jun Park, Wonju Severance Christian Hospital
HELP-A is a prospective, randomized, open-label, multicenter comparative-effectiveness trial comparing two ambulatory electrocardiographic monitoring strategies in adults with palpitations or dizziness and a nondiagnostic 12-lead ECG. A total of 588 participants are randomized 1:1 to 30-day intermittent handheld 6-lead ECG monitoring (Hativ) or up to 7 days of continuous single-lead patch ECG monitoring (Memo Patch). The primary endpoint is clinically informative symptom-rhythm correlation established with the initially assigned device by the 1-month follow-up visit. Participants without a symptom-rhythm correlation who remain symptomatic may undergo optional sequential monitoring with the alternative device after primary endpoint ascertainment. Clinical outcomes, arrhythmia-directed interventions, healthcare resource utilization, costs, and adverse events are assessed through 3 months.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

HELP-A is an investigator-initiated, prospective, randomized, open-label, multicenter comparative-effectiveness trial conducted at four tertiary hospitals in South Korea. The study evaluates two ambulatory ECG monitoring strategies in adults with palpitations or dizziness that are not explained by a presenting 12-lead ECG and for whom additional ambulatory rhythm monitoring is clinically indicated.

Participants are randomized in a 1:1 ratio, stratified by participating center, to one of two monitoring strategies. Participants assigned to Hativ use a handheld ECG device that provides 10-second 6-lead ECG recordings. They are instructed to record at least twice daily and whenever symptoms occur for 30 days. Participants assigned to Memo Patch undergo continuous single-lead ECG monitoring for up to 7 consecutive days and report symptom onset using a mobile messaging chatbot or paper diary. For each reported symptom, a 20-minute ECG segment from 10 minutes before to 10 minutes after the reported onset is available for review.

The primary endpoint is clinically informative symptom-rhythm correlation established with the initially assigned device by the 1-month follow-up visit. A positive correlation requires an interpretable ECG obtained during a participant-confirmed typical symptomatic episode with a rhythm finding judged to be temporally and clinically concordant with that episode. A negative-only correlation requires at least one qualifying symptomatic episode with an interpretable ECG showing no concordant rhythm finding and no positive correlation by the 1-month visit. Both positive and negative-only correlations count as primary-endpoint success.

Because the assigned monitoring durations differ, a prespecified key secondary analysis re-ascertains the primary endpoint using only data from the first 7 days after randomization, representing the common planned 7-day monitoring window. Clinically significant arrhythmia is evaluated separately from symptom-rhythm correlation and is adjudicated centrally using prespecified device-specific operational definitions.

After completion of the 1-month primary endpoint assessment, participants with persistent symptoms and no clinically informative symptom-rhythm correlation may undergo optional sequential monitoring with the alternative device if further monitoring remains clinically appropriate and the participant agrees. Data obtained during sequential monitoring do not contribute to the primary randomized comparison and are analyzed as exploratory outcomes.

All randomized participants are followed through 3 months. Follow-up includes arrhythmia-directed therapeutic interventions, clinical events, healthcare resource utilization and costs, adverse events, and selected patient-reported outcomes.

Study Type

Interventional

Enrollment (Estimated)

588

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Dong-gu Jaebongro 42
      • Gwangju, Dong-gu Jaebongro 42, South Korea, 61469
        • Recruiting
        • Chonnam National University Hospital
        • Contact:
    • Gangwon-do
      • Wŏnju, Gangwon-do, South Korea, 26426
    • Hwaseong-si Keunjaebong-gil 7
      • Gyeonggi-do, Hwaseong-si Keunjaebong-gil 7, South Korea, 18450
        • Recruiting
        • Hallym University Dongtan Sacred Heart Hospital
        • Contact:
    • Seongbuk-gu, 73 Goryeodae-ro
      • Seoul, Seongbuk-gu, 73 Goryeodae-ro, South Korea, 02841
        • Recruiting
        • Korea University Anam Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age 19 years or older.
  • Palpitations or dizziness not explained by the presenting 12-lead ECG.
  • A clinical indication for additional ambulatory ECG monitoring.
  • Ownership of and ability to use a compatible smartphone.
  • Ability to provide written informed consent and comply with study procedures

Exclusion Criteria:

  • Physical disability or another condition that prevents appropriate use of the handheld ECG device.
  • Presence of a cardiac implantable electronic device or ventricular assist device.
  • Inability to read or understand the informed consent document.
  • Any other condition that, in the investigator's judgment, makes participation in the study inappropriate.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Memo Patch continuous ECG strategy
Participants undergo continuous single-lead ECG monitoring with Memo Patch for up to 7 consecutive days and report symptom onset using a mobile messaging chatbot or paper diary.
Continuous single-lead ECG monitoring for up to 7 consecutive days. Participants report the onset of symptoms using a mobile messaging chatbot or paper diary. For each reported symptomatic episode, a 20-minute ECG segment extending from 10 minutes before to 10 minutes after the reported onset is available for review.
Active Comparator: Hativ handheld ECG strategy
Participants use Hativ for 30 days and perform 10-second 6-lead ECG recordings at least twice daily and whenever symptoms occur.
Handheld ECG monitoring using 10-second 6-lead recordings obtained at least twice daily and additionally whenever symptoms occur for 30 days. Recordings are transmitted through the companion smartphone application to a secure study server.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinically informative symptom-rhythm correlation with the initially assigned device by 1 month
Time Frame: From randomization through the 1-month follow-up visit
Proportion of randomized participants with at least one participant-confirmed typical symptomatic episode documented with an interpretable ECG using the initially assigned device by the 1-month follow-up visit and before optional sequential monitoring. Primary-endpoint success comprises either a positive symptom-rhythm correlation or a negative-only symptom-rhythm correlation. A positive correlation is a qualifying symptomatic episode with an interpretable ECG showing a rhythm finding judged by central adjudication to be temporally and clinically concordant with that episode. A negative-only correlation requires at least one qualifying symptomatic episode with an interpretable ECG showing no concordant rhythm finding and no positive correlation by the 1-month visit.
From randomization through the 1-month follow-up visit

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Positive symptom-rhythm correlation
Time Frame: By the 1-month follow-up visit
Proportion of participants with at least one qualifying participant-confirmed typical symptomatic episode documented with an interpretable ECG showing a rhythm finding judged by central adjudication to be temporally and clinically concordant with that episode.
By the 1-month follow-up visit
Negative-only symptom-rhythm correlation
Time Frame: By the 1-month follow-up visit
Proportion of participants with at least one qualifying participant-confirmed typical symptomatic episode documented with an interpretable ECG showing no temporally and clinically concordant rhythm finding and with no positive correlation by the 1-month follow-up visit.
By the 1-month follow-up visit
Both positive and negative episodes
Time Frame: By the 1-month follow-up visit
Proportion of participants with at least one qualifying positive symptom-rhythm correlation and at least one qualifying negative symptom-rhythm correlation. This measure is descriptive.
By the 1-month follow-up visit
Clinically significant arrhythmia detected during assigned-device monitoring
Time Frame: By the 1-month follow-up visit
Proportion of participants with at least one centrally adjudicated clinically significant arrhythmia detected during initially assigned-device monitoring, irrespective of symptom association. Clinically significant arrhythmias are classified using prespecified device-specific operational definitions. Findings are additionally classified as symptom-associated or not temporally associated with a qualifying typical symptomatic episode.
By the 1-month follow-up visit
Arrhythmia-directed therapeutic intervention
Time Frame: Through 3 months after randomization
Rate and timing of arrhythmia-directed therapeutic interventions, including medication, catheter ablation, or cardiac device implantation.
Through 3 months after randomization
Overall satisfaction
Time Frame: 1-month follow-up visit
Overall device satisfaction measured using the prespecified ordinal response scale in the 1-month participant questionnaire.
1-month follow-up visit
EQ-5D-5L
Time Frame: Baseline to 1 month
Change in the EQ-5D-5L index score from enrollment to the 1-month follow-up visit.
Baseline to 1 month
Healthcare resource utilization and costs
Time Frame: Through 3 months after randomization
Arrhythmia-related healthcare resource use through 3 months, including additional diagnostic tests, arrhythmia-related medications, emergency department visits, and hospitalizations. Costs are derived from institutional billing records at participating centers and expressed in Korean won. The base-case analysis excludes acquisition cost of the study devices because the devices were supplied in kind.
Through 3 months after randomization
Safety Outcome
Time Frame: Through 3 months after randomization
Number and proportion of participants experiencing device-related or serious adverse events. Expected device-related events include skin irritation or contact dermatitis associated with the adhesive patch and discomfort associated with device use.
Through 3 months after randomization

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sequential-monitoring participant questionnaire
Time Frame: 3-month follow-up
Among participants who undergo optional sequential monitoring with both study devices, paired ratings of device usability, overall satisfaction, preference, willingness to recommend, and willingness to use each device again are collected using the 3-month head-to-head questionnaire. This analysis is exploratory because eligibility for sequential monitoring depends on the outcome of the initially assigned strategy
3-month follow-up

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Young Jun Park, MD, Wonju Severance Christian Hopsital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 22, 2024

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

December 31, 2026

Study Registration Dates

First Submitted

January 31, 2024

First Submitted That Met QC Criteria

February 7, 2024

First Posted (Actual)

February 9, 2024

Study Record Updates

Last Update Posted (Actual)

September 4, 2026

Last Update Submitted That Met QC Criteria

September 1, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • CR223024

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data underlying the primary publication, together with a data dictionary, will be available from the corresponding investigator on reasonable request after completion of the study and publication of the primary results, subject to ethics approval and execution of an appropriate data-use agreement.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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