Applications of Smart Textiles for Ambulatory Electrocardiogram Monitoring: Scoping Review of the Literature

Background: Smart textiles (ie, electronic textiles) offer a promising solution to ease continuous electrocardiogram (ECG) monitoring, but their real-world clinical application has been limited. Objective: This review comprehensively examines the current state of research on textile-based ECG monitoring systems, synthesizing current evidence with respect to performance (ie, signal quality, function under static and dynamic conditions), user experience, and current challenges. Methods: A systematic literature search across the PubMed, MEDLINE, and Embase databases from 2000 to 2025 identified 34 research papers eligible for inclusion. Results: Textile-based ECG electrodes demonstrated good signal quality and comfort, particularly under static conditions. Nonetheless, integration into clinical practice requires addressing critical issues, which include greater efforts at validating these technologies in clinical settings and populations, as well as ensuring data security, cost‑effectiveness, user‑friendliness, and data interoperability. Conclusions: Considering the prominence of feasibility research, the successful clinical integration of textile-based ECG monitoring systems requires comprehensive efforts at establishing a clinical evaluation research base (via clinical trials) and developing regulatory policies.