Objective To evaluate the effectiveness of a wearable 12-lead intelligent ECG vest for post-procedural monitoring following pulmonary vascular intervention. Methods Eighty-eight patients undergoing pulmonary vascular intervention were randomized to receive post-procedural monitoring with either a traditional ECG device (control group, n=44) or a non-invasive wea-rable intelligent ECG vest (observation group, n=44). Arrhythmia detection rates within post-operative 24 h, patient comfort, and nursing staff satisfaction were compared between the two groups. Results Compared to the control group, the observation group demonstrated significantly higher detection rates for premature complexes, abnormal heart rate variability, and atrial tachycardia (all P<0.05). Patient comfort and nursing staff satisfaction were also significantly higher in the observation group (both P<0.05). Conclusion The wearable intelligent ECG vest provides enhanced patient comfort and facilitates real-time arrhythmia identification, thereby improving patient safety during post-procedural ambulatory monitoring.