Novel technology available termed ambulatory long term continuous monitor (LTCM) one of which includes Zio XT has the capability to record and store continuous ECG for up to 14 days. Long Term Cardiac Telemetry provides beat-to-beat ECG recording, storage and analysis with automatic arrhythmia detection. The ZIO XT device utilizes an adhesive patch which attaches conveniently to the patient. The LTCM has the capability to detect AF of duration less than 2 minutes when compared to the ILR. The patches are disposable and may be worn for up to 14 days duration. . The Zio patch They contains a proprietary algorithm which can detect a number of different arrhythmias including but not limited to non-sustained ventricular tachycardia, brady- arrhythmia including heart block as well as life threatening polymorphic ventricular tachycardia. LTCMs are substantially cost effective and may be used in clinics or emergency departments. The LTCMs however have not been studied in a comparative effectiveness trial with implantable loop recorders.