Pacemaker Memory Data Compared to Twenty‐Four‐Hour Holter Monitoring in Patients with VVI Pacemakers and Chronic Atrial Fibrillation

BACKGROUND: In light of the results from the AFFIRM trial, the "rate control" strategy has become an accepted treatment modality for patients with atrial fibrillation (AF). Establishing effective rate control requires long-term monitoring of the heart rate. The aim of the study was to compare the heart rate and rhythm monitoring capabilities of the pacemaker memory data (PMD) algorithm and traditional twenty-four-hour Holter monitoring. METHODS: The study included 55 patients with chronic AF and a permanent VVI pacemaker. The mean and maximum heart rate as well as the percentage of sensed and paced events obtained from the twenty-four-hour Holter were compared with the results retrieved from PMD, started simultaneously. The study was performed over two consecutive days with pacemakers programmed in VVI 40 and 80 bpm mode. RESULTS: Data retrieved from PMD regarding percentage of sensed and paced episodes as well as mean heart rate strongly correlated with data obtained from twenty-four-hour Holter monitoring. The maximum heart rate reported by PMD was significantly higher than that found in the Holter. CONCLUSIONS: PMD provides accurate information regarding long-term monitoring of heart rate in patients with AF who have an implanted permanent pacemaker and thus may facilitate optimized drug therapy to achieve rate control of AF.