The impact of stored atrial rhythm diagnostics in permanent pacemakers and the management of atrial fibrillation: The Vitatron Selection AFm Registry study

The Selection AFm Registry investigated the impact of pacemaker diagnostic data on the clinical management of patients with atrial arrhythmias, specifically atrial fibrillation (AF) through the use of advanced atrial arrhythmia monitoring features. Very few data on the clinical impact of such data has been reported in a real world setting. Methods: Patients with known or suspected AF with a Class I or Class II indication for a dual-chamber pacemaker received the Selection AFm pacemaker. These patients were prospectively followed at pacemaker follow-up visits, and data were collected on medications and device programming. Physicians identified which therapy changes were based upon the stored data within the pacemaker. Results: Two hundred eighty-two patients were enrolled. A total of 119 patients had 311 changes made to either their medications or device programming after review of diagnostic pacemaker data. Changes involved rate and rhythm control, warfarin anticoagulation, and pacemaker programmed settings. Significantly, more changes were made in patients with documented atrial arrhythmias at follow-up. Conclusions: The atrial arrhythmia recording features were used by clinicians to guide therapy-related decisions in patients with paroxysmal AF. Such data represent an additional source of clinical information for AF disease management.