Our approach
Decades of experience. A standardised approach to every recording.
ACE Health's roots in ECG analysis go back to 1977, when Fysiologic began delivering Holter reports to clinicians across the Netherlands. Nearly five decades later, the clinical principles that defined that work remain unchanged: every recording deserves careful, expert review, and every report must be reliable enough to inform a clinical decision.
What has changed is scale and infrastructure. Today, 160 certified analysts process recordings across seven countries, supported by AI-assisted pre-classification and a purpose-built platform. The combination of clinical experience and modern tooling is what allows us to maintain consistent quality at volume and to turn reports around within three business days as standard.
Our approach is not automated reporting with a human check at the end. It is analyst-led review, supported by technology, governed by a structured quality framework.
How we analyze a recording
Every recording that arrives at ACE Health follows the same structured workflow, from upload to report delivery. When a recording is received, it is pre-classified by AI-assisted software, which identifies candidate events and assigns an initial quality assessment. This pre-classification supports the analyst, but it does not replace them. The analyst reviews the full recording, validates or revises the automated findings, and applies ACE's standardised reporting conventions throughout.
Where a recording presents particular complexity, or where quality thresholds indicate that additional review is warranted, a second analyst independently reviews the report before it is released. This additional review layer ensures that our most challenging cases receive the scrutiny they require.
The completed report is released through Sinus and delivered to the referring clinician, directly into their patient management system where HL7 integration is in place, within three business days.
Emergency protocol
When a recording contains findings that may require urgent clinical attention, our analysts contact the referring clinician directly even before the formal report is finalised — so that patient care is not delayed.
What the report covers
A Holter recording captures continuous cardiac activity over an extended period, 24 hours or longer. Because a standard 12-lead ECG only captures a brief snapshot, many clinically relevant events occur between appointments and go undetected without ambulatory monitoring. Although a 12-lead ECG captures much more information at a given time, a Holter with its two or three leads is plenty to detect a range of clinically relevant events. Our analysts review each recording and compile a list of the following findings:
Heart rate and heart rate variability across the recording period, including minimum, maximum, and average values, and day-night variation.
Rapid or irregular rhythm episodes, including atrial fibrillation and flutter, supraventricular tachycardia, and ventricular tachycardia. Reports include the burden, duration, and timing of any identified episodes.
Bradycardias, pauses, and conduction abnormalities such as AV blocks, sinus arrest, sinus bradycardia, and intraventricular conduction disturbances.
QT and PR interval data.
Where a patient diary has been used, our analysts correlate reported symptoms with the cardiac activity recorded at those moments. This assists the referring clinician in determining whether a patient's symptoms coincide with a recorded event.
