TO BE COMPLETED BY PATIENT
USING THE
Based on individual wear experiences your actual
wear time may be shorter than prescribed.
Open for Patient Instructions and FAQs.
Press the ‘ZIO’ button.
Write the symptom in the Button Press Log.
On cover, write in “Date Removed.”
See last page for how to remove the ZIO® XT Patch.
How long am I supposed to wear the ZIO® XT Patch?
Wear the ZIO® XT Patch according to your physician
prescribed wear time but no longer than 14 days.
NOTE: Based on individual wear experiences your
actual wear time may be shorter than prescribed.
Yes, but keep showers short and keep soaps and
lotions away from the ZIO® XT Patch.
Yes, but keep the ZIO® XT Patch above water. The
ZIO® XT Patch should not be submerged in water.
ZIO® XT Patch is on?
No.
What if I don’t have symptoms?
That’s okay. The ZIO® XT Patch is designed to
capture every beat.
Yes, but activities that cause excessive sweating can
cause the ZIO® XT Patch to slide, become
loose, fall o, and shorten wear time.
If it is working properly, the ZIO® XT Patch will not
flash or make noise.
What if the ZIO® XT Patch falls o?
Call Customer Support. We are available 24 hours a
day, 7 days a week.
How do I return the ZIO® XT Patch?
Place it (along with the Patient Instructions & Button
Press Log) in the original postage-paid box and drop
it o at the Post Oce, in a USPS (blue) mailbox or
give it to your mail carrier.
Button PREss Log
...while I was
...because I felt:
anxious
arm or neck
pain/tingling
chest pain
or pressure
dizziness
fainted
light headed
pounding
fluttering or racing
short of breath
skipped beat(s),
irregular beats
other (describe):
I pressed the button on...
describe
activity
minorless
minsorless
...for this duration:
hourorless
Morethanhour
:
h m m
AM
PM
hm d ym d y
12
Do not use the ZIO® XT Patch on patients with known
allergic reactions to adhesives or hydrogels or have a
family history of adhesive skin allergies.
Do not use the ZIO® XT Patch in combination with external
cardiac defibrillators or high frequency surgical equipment.
Do not use the ZIO® XT Patch near strong magnetic fields
or devices such as MRI.
Do not use the ZIO® XT Patch on patients with a neuro-
stimulator, as it may disrupt the quality of ECG data.
Do not use the ZIO® XT Patch on patients who do not have
the competency to wear the device for the prescribed
monitoring period.
CAUTION: Federal (USA) law restricts the sale of this
device to or on the order of a physician.
N100A4710.04 | Mar. 2014
FOR SUPPORT, CALL 1.888.693.2401
iRhythm Technologies, Inc. | irhythmtech.com | @iRhythmTech