Research during the 4Days Marches on the impact of walking on heart rhythm  Study using an innovative patch-based Holter to detect atrial fibrillation provides insights into heart rhythm during physical activity

During the 4Days Marches, Radboudumc is working with Philips in conducting research into the effects of walking on atrial fibrillation, a common heart rhythm disorder. A total of 140 people with atrial fibrillation are participating in the study. Sixty of them are walking the 4Days Marches while wearing a Philips ePatch: a wearable heart rhythm Holter monitor in the form of a patch on the chest. This is one of the first large-scale studies to examine the effect of prolonged physical exertion on atrial fibrillation.

• Approximately 400,000 people in the Netherlands have been diagnosed with atrial fibrillation, a condition that increases the risk of stroke or heart failure. 
• Sixty participants participate in the 4Days Marches while wearing a Philips ePatch for continuous heart rhythm monitoring to better understand the effect of walking on atrial fibrillation. 
• The study is part of the 17th 4Days Marches research project by Radboud university medical center (Radboudumc).

Atrial Fibrillation: common but often undetected 

In the Netherlands, around 400,000 people have been diagnosed with atrial fibrillation. The condition causes an irregular, rapid heartbeats and can lead to symptoms such as palpitations, fatigue, or shortness of breath. While not immediately life-threatening, atrial fibrillation significantly increases the risk of stroke or heart failure. It is estimated that over 80,000 Dutch people have atrial fibrillation without knowing it. Early detection and appropriate treatment are therefore crucial. 

‘We want to understand the effects of the training leading up to the 4Days Marches and participation in the event itself on atrial fibrillation,’ says Maria Hopman, Professor of Physiology at Radboudumc. With her team, she is studying participants in the months before the event and during the walking days themselves. ‘It’s unique to be able to monitor walkers in this way, being able to evaluate 24 hours a day across multiple days and under physical stress,’ Hopman explains. In addition to the data collected by the ePatch, researchers are also examining blood pressure, weight, and blood values. Participants also complete questionnaires. For some walkers, an echocardiogram is performed after several stages to image their hearts following the walking.

Wearable sensor measures heart rhythm day and night 

The Philips ePatch is a wearable sensor about the size of half a matchbox that continuously records heart rhythm. Unlike traditional Holter monitors with wires and adhesive electrodes, the sensor is comfortable, wireless, and discreet—and can be used even during showering, sleeping, and exercising. The ePatch can be worn for up to five days and records heart rhythm throughout. For patients, this means significantly less discomfort during long-term monitoring. The collected data are analyzed quickly and accurately using artificial intelligence (AI).

‘We are very proud to support Radboudumc during the 4Days Marches in a study on the effect of walking on atrial fibrillation,’ says Léon Kempeneers, Managing Director of Philips Benelux. ‘The ePatch is designed for long-term use and comfort, and we hope the walkers experience it that way too. Our ePatch and AI-powered software can help diagnose people with heart rhythm disorders in a more pleasant and effective way. The ePatch and its software are already being used by several Dutch healthcare institutions.’ 

Professor of Physiology Maria Hopman.

About the 4Days Marches Research 

This year marks the 17th 4Days Marches research event. Professor of Physiology Maria Hopman and her team will be stationed at the research center near the start and finish location of the 4Days Marches in Nijmegen. Here are some highlights from the past 16 years: 

• The first walking day is the most physically challenging. 
• Body temperature increases by 1 degree Celsius during a walking day. 
• 20% of walkers drink too little during a walking day. 
• Heart damage occurs after a walking day and may predict cardiovascular diseases. 
• Type 2 diabetes patients need less medication as they train more for the 4Days Marches. 
• Walkers around 80 years old are estimated to be 8.2 years younger in biological age. 
• Walking 30-40 minutes a day reduces the risk of cardiovascular diseases. 
• Statin users do not experience more muscle pain and damage after a walking day than other walkers.
• The older the walker, the poorer the thermoregulation. 
• Extra vegetables lower blood pressure in walkers with hypertension. 

In addition to the research on atrial fibrillation, studies are also being conducted this year during heatwaves on the effect of clothing color (white vs. black) and wearing a cap on body temperature.

Read more about the 4Days Marches on our webpage.

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