Next-Gen Holter Monitoring: Continuous ECG Without the Hassle

Traditional Holter monitors capture only 24 to 72 hours of ECG data, limiting the ability to detect cardiac abnormalities that may not occur within this short window. While patch monitors extend monitoring to 14 days, may cause skin irritation and capture low-quality data during movement. The Frontier X Plus, FDA 510(k) cleared ECG monitor, provides a comprehensive solution by offering both short-term (24–48 hours) and long-term (15–30 days) ECG monitoring in a single, compact device. With extended monitoring, it improves the ability to detect cardiac events that may otherwise go unnoticed, leading to better patient outcomes.

Traditional Holter monitors capture only 24–72 hours of ECG data, limiting detection of abnormalities outside this window. Disposable patches extend to 14 days but may cause skin irritation and record poor-quality data during exercise. The FDA-cleared Frontier X Plus provides both short-term (24–48 hrs) and long-term (15–30 days) ECG monitoring in one compact device.With extended monitoring, it improves the ability to detect cardiac events that may otherwise go unnoticed, leading to better patient outcomes.

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Detect exercise-induced arrhythmias with precision

The Frontier X Plus delivers ECG signals with minimal motion artifacts, ensuring precise detection of exercise-induced arrhythmias. Its wire-free design allows seamless monitoring during movement, providing reliable data for confident clinical decisions.

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Faster report turn around time

Reports are made available within 24 hours of the End-of-Study. Our continuous data streaming technology ensures that data can be uploaded and reviewed every 24 hours. Clinicians can access live insights without waiting for manual uploads, accelerating diagnosis and decision-making. This allows for quicker detection of cardiac irregularities, leading to timely interventions

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A cost-effective solution

The Frontier X Plus is rechargeable, reusable, and fits into existing workflows without additional investment. Self-applied by patients, it eliminates staff dependency, reduces labor costs, and streamlines arrhythmia detection and ECG data review.

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Empower patients with a comfortable, self-applied ECG monitor

The lightweight, chest strap-based design ensures comfort and ease of use. Patients can apply it independently, reducing clinic visits while ensuring continuous, reliable ECG monitoring for better long-term compliance.

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Remote ECG monitoring for better patient care

The Frontier X Plus provides continuous, high-quality ECG data accessible via a remote dashboard. Healthcare providers can track arrhythmias, detect early warning signs, and adjust treatments, improving patient outcomes while reducing hospital visits. You can leverage existing CPT codes 93224-93227, 93241-93244, 93245 - 93248, 0937T - 0940T for reimbursement. Note: Billing reimbursement has been validated by certified CPT coders

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Seamless EMR & Holter Integration

The Frontier X Plus platform integrates with leading EMR systems like EPIC and Cerner, as well as top Holter reporting platforms. This ensures ease of adoption, smooth data transfer, streamlined workflows, and enhanced clinical efficiency.

What Sets Frontier X Plus Apart

Early Atrial Fibrillation Detection

Continuously records high-quality ECG and offers automated AFib detection, enabling early diagnosis and timely intervention for better patient outcomes.

Enhance Diagnostic Yield with Extended ECG Monitoring

Frontier X Plus offers 24-hour to 30-day ECG monitoring, ensuring better cardiac event detection than Holter or patch monitors.

Clinically Proven Accuracy

Offers 98.10% sensitivity and 97.88% specificity for AFib detection, clinically validated against an FDA-cleared 12-lead ECG.

Wireless ECG Monitoring for All-Day Comfort

Ensures unmatched freedom with its adhesive-free, wire-free design, preventing skin irritation & discomfort.

Rechargeable & Reusable for Long-Term Monitoring

Reusable design ensures cost-effective, long-term ECG monitoring without recurring replacement costs.

Faster ECG Reports for Quicker Diagnosis

Enables rapid report generation and its quick turnaround time ensures faster clinical decisions, reducing delays in patient care.

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Certifications

*Disclaimer: HIPAA Compliant AWS server, RoHS2 & Reach Compliant chest strap.

Next-Gen Cardiac Monitoring: Beyond Holter

Next-Gen Cardiac Monitoring: Beyond Holter

Fourth Frontier is Trusted by Leading Cardiologists,
Cardiac Rehab Centers, and Researchers Globally

Fourth Frontier is Trusted by Leading Cardiologists, Cardiac Rehab Centers, and Researchers Globally

18,000+ Users Worldwide
150,000,000+ Minutes of ECG Recorded
26,000+ Events Detected

Technical Safety and Performance Testing

Frontier X Plus Device

  • IEC 60601-2-47:2014 Medical Electrical Equipment Part 2-47: Particular Requirements for the safety. Including essential performance of ambulatory electrocardiographic systems.
  • IEC 60601-1:2005, AMD1:2012 Medical Electrical equipment - Part 1:General requirements for basic safety and essential performance.
  • IEC 60601-1-2:2014 +AMD1: 2020 CSV, Medical Electrical Equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic disturbances Requirements and tests.
  • IEC 60601-1-11:2015 Medical Electrical Equipment - Part 1-11: General requirements for basic safety and essential performance - Collateral standard: Requirements for medical electrical equipment and medical electrical systems used in the home healthcare environment.

Chest Strap

  • Compliant with REACH and RoHS2 standards.

Clinical Validation

This study aimed to validate the Frontier X Plus (FX+) single-lead, continuous ECG device by comparing its performance against the traditional FDA Cleared 12-lead ECG in ​832 patients​ in both a clinical and real world setting including individuals with and without atrial fibrillation (AFib). The performance of the Frontier X Plus in detecting atrial fibrillation (AF) demonstrated a sensitivity of 98.10% and a specificity of ​97.88%, when compared to the paired gold standard device as adjudicated by 3 independent cardiologists.

Publications

Roberts, William O. MD, MS, FACSM1; Levine, Benjamin D. MD, FACSM2

A case report of a 16-year-old competitive runner experiencing sudden-onset tachycardia episodes, exceeding 200 bpm, documented using a Garmin Instinct™ watch. Despite normal cardiac evaluations, the patient later used a Frontier X™ ECG Fitness Tracker, which successfully captured heart rhythm data during episodes and helped monitor his response to beta blocker therapy.

Ciara McCormack, Brona Kehoe, Sarah Cullivan, Noel McCaffrey, Sean Gaine, Brian McCullagh, Andrew McCarren, Sarah J Hardcastle, Niall M Moyna

The Frontier X device played a crucial role in continuously monitoring heart rate and respiratory rate, ensuring safety and enabling real-time feedback during the exercise sessions. The success of this remotely delivered intervention suggests that similar models could be effectively implemented for broader PH patient populations, offering a scalable alternative to hospital-based programs.

FAQ’s

What is Frontier X Plus?

Frontier X Plus™ by Fourth Frontier® is a wearable ambulatory electrocardiogram (EKG or ECG) recorder and display product affixed to the chest strap, a companion mobile application, and a web application for analysis of ECG. It is a novel, self-applied continuous ambulatory ECG solution for arrhythmia detection and management.

The Frontier X Plus system also displays ECG waveform and ECG rhythm analysis; detecting the presence of normal sinus rhythm, atrial fibrillation, bradycardia, tachycardia, and inconclusive and unreadable rhythms. The device is intended for use by healthcare professionals, patients with known or suspected heart conditions and health-conscious individuals. It is indicated for use on adult patients who may be asymptomatic or who may suffer from transient symptoms requiring cardiac monitoring. This chest heart rate monitor is a non-invasive, lightweight, rechargeable battery- operated wireless ambulatory ECG monitor.

How can the Frontier X Plus device enhance the services provided by health systems and diagnostic centers?

The Frontier X Plus device allows health systems and diagnostic centers to offer advanced heart monitoring solutions by enabling patients to record and transmit ECGs through a web application. 

With continuous data transmission, you no longer have to wait for patients to complete their monitoring period before accessing critical insights. Continuous data allows for faster clinical decision-making, enabling you to detect abnormalities early and intervene when it matters most. This improves patient outcomes and helps you deliver a higher standard of care.

The Frontier X Plus simplifies the process of patient onboarding, allowing you to onboard patients quickly and efficiently without the delays often associated with traditional monitoring systems. This means you can see more patients, reduce wait times, and optimize your workflow—all while maintaining accuracy.

If you’ve struggled with signal quality during exercise, this device ensures clear, reliable data even in motion. Unlike traditional ECG solutions that may lose accuracy during activity, the Frontier X Plus provides consistent readings with minimal motion artifacts.

The Frontier X Plus can be easily self-applied by the patients, reducing your resource burden and freeing up your team to focus on higher-priority tasks. With fewer manual interventions, you can improve operational efficiency while still maintaining high-quality diagnostics.

By integrating the Frontier X Plus into your practice, you gain a scalable, cost-effective solution that enhances your diagnostic capabilities, improves patient care, and positions your facility at the forefront of advanced cardiac monitoring.

How can the Frontier X Plus address the data management challenges faced by health systems and diagnostic centers such as handling large volumes of data, ensuring continuous monitoring, and maintaining compatibility with existing workflows?  

The Frontier X Plus ECG monitor is designed to help you overcome data management challenges and streamline operations.

With centralized monitoring, your team can easily track multiple patients simultaneously using a user-friendly dashboard. This allows for a clear, continuous overview of all active devices and patient data, ensuring smoother workflow and better patient management.

Remote signal validation enables you to verify ECG signal quality through live streaming, reducing the need for in-person troubleshooting and minimizing data errors. This means fewer disruptions and greater efficiency in managing patient diagnostics.

For seamless account management, your admin account can oversee multiple patient profiles effortlessly using the Frontier X Plus monitor and application. This scalable setup ensures your facility can handle increasing patient loads while maintaining efficiency and organization.

You also benefit from flexible data access and compatibility. The ability to download raw ECG data in multiple formats and integrate it with your existing systems ensures smooth interoperability, making it easier to analyze and store patient records.

By simplifying data handling, improving workflow efficiency, and reducing manual intervention, the Frontier X Plus, the best heart monitor, allows you to focus on what matters most—delivering high-quality diagnostic services and improving patient outcomes.

How does the Frontier X Plus improve patient management and diagnosis times?

With the Frontier X Plus, you get fast ECG report turnaround times, ensuring efficient patient management and quicker diagnosis. Reports are available within 24 hours of the End-of-Study, and continuous data streaming allows data to be uploaded and reviewed every day.

Clinicians can access live insights without waiting for manual uploads, enabling faster detection of cardiac irregularities and timely interventions. This streamlined process enhances patient care outcomes and supports more proactive treatment decisions.

Does the Frontier X Plus reduce motion artifacts in ambulatory ECG monitoring?

Yes, its advanced technology ensures clean, reliable ECG signals, even during patient movement or exercise, significantly minimizing motion artifacts and noise. This reduces false positives and missed diagnoses, common with traditional devices. By delivering precise data for arrhythmia detection, the Frontier X Plus enhances clinical confidence and improves overall quality control in ambulatory ECG services.

How does the Frontier X Plus help diagnostic facilities address concerns about battery life and durability during long-term ECG monitoring?

The Frontier X Plus is designed to address these challenges effectively. It features a rechargeable battery that lasts up to 24 hours of continuous ECG monitoring on a single full charge. To further optimize battery life, the device automatically enters sleep mode after 5 minutes of inactivity, reducing unnecessary power consumption. In the event that the battery runs low, the charging time from 0 to 100% is typically under 3 hours, ensuring quick turnaround times between uses. Additionally, the Frontier X Plus is built to withstand up to 500 full charge cycles, providing long-term reliability without sacrificing accuracy or durability, making it an ideal solution for diagnostic centers handling long-term ambulatory ECG monitoring.

How does Frontier X Plus ensure HIPAA compliance when transmitting or storing ECG data?

The Frontier X Plus, 510(k)FDA cleared heart rate monitor, ensures compliance by storing and processing all patient data on HIPAA-compliant AWS servers. These servers are designed with robust security measures to protect sensitive information, including encryption, access control, and regular audits to meet stringent privacy and data security regulations. This ensures that all ECG data remains secure throughout the transmission and storage processes, providing peace of mind for both patients and diagnostic centers.

How can my diagnostic facility take advantage of the Frontier X Plus to minimize costs?

The Frontier X Plus helps minimize costs by eliminating the need for expensive single-use devices with its rechargeable, reusable design. Patients can self-apply the device, reducing staff dependency and labor costs. It seamlessly integrates into your existing infrastructure, ensuring a smooth, cost-effective transition. With automated arrhythmia detection, it streamlines workflows, enabling efficient, accurate diagnostics with minimal setup costs. This combination of low investment, high accuracy, and ease of use supports financial sustainability while delivering high-quality ECG monitoring.

How does Frontier X Plus address staff training challenges in setting up and using ambulatory ECG devices?

The Frontier X Plus is self-applied, eliminating the need for staff assistance and reducing training requirements. Its user-friendly design makes setup easy for any adult familiar with mobile apps, minimizing operational constraints. With customized support, personal account management, and free technical assistance, the device ensures smooth operation and troubleshooting. While ECG interpretation remains with physicians, its simplicity streamlines workflows and reduces staff training burdens.

Can I get reimbursement using the Frontier X Plus?

Yes. You can leverage existing CPT codes 93224-93227, 93241-93244, 93245 - 93248, 0937T - 0940T for reimbursement.

Note: Billing reimbursement has been validated by certified CPT coders

Note:

The Frontier X Plus (FX+) is a prescription only US FDA 510(k) cleared medical device for ambulatory ECG monitoring. It is not tested for use in individuals with pacemakers or ICDs. It is not meant for the diagnosis of cardiac ischemia. Please request the IFU for intended use, indications, contraindications and availability in your geography.

Disclaimer: All images used are for illustrative purposes only.