title: Clinical use of automatic pacemaker algorithms: results of the AUTOMATICITY registry.
abstract: OBJECTIVE
  Follow-up of the ever-increasing numbers of patients with implantable cardiac devices places a heavy burden on clinical departments. Device automaticity may alleviate the follow-up burden by minimizing the time for physician involvement. The aim of the prospective, multicentre AUTOMATICITY registry was to examine the performance of a subset of programmed automatic algorithms during patient follow-up and their acceptance by implanting physicians.
  
  
  RESULTS
  The clinical use of automatic algorithms from the Insignia pacemakers (PM; Boston Scientific, St Paul, MN, USA) was evaluated: atrial and ventricular AutoSense (sensitivity adjustment), ventricular Automatic Capture (threshold verification and output setting), AutoLifeStyle (sensor settings adjustment). The objective of the study was to assess the reprogramming rates within 12 months of implant, the reasons for reprogramming and relationship to adverse events. A total of 960 patients were enrolled in the study. The proportion of patients free from any algorithm reprogramming at 12 months was 86.1%. A total of 2736 algorithms were activated at enrolment, with 156 (5.7%) being reprogrammed in 115 patients at 12 months for any reason. Forty-nine reprogrammings (1.8%) were unintentional or related to changes in device settings such that the algorithm was no longer available, 33 (1.2%) were due to suspected sensing issues, and 22 (0.8%) were assumed related to the algorithm. The individual 12-month reprogramming-free rates were: ventricular AutoSense 94.3%, Atrial AutoSense 93.3%, AutoLifeStyle 93.9%, and Automatic Capture 95.9%.
  
  
  CONCLUSIONS
  The results of the AUTOMATICITY registry show that automatic measurement of key settings and automatic adjustment to optimal programming is feasible and safe. The simplicity of PM follow-up and avoidance of frequent reprogramming may contribute to a more effective use of hospital time and resources.
authors.affiliation: Amphia Ziekenhuis, Molengracht 21, 4818 CK Breda, The Netherlands. MAilings@Amphia.nl
authors.forename: Marco
authors.initials: M
authors.lastname: Alings
authors.forename: Elisa
authors.initials: E
authors.lastname: Vireca
authors.forename: Dirk
authors.initials: D
authors.lastname: Bastian
authors.forename: Alexander Jacques
authors.initials: AJ
authors.lastname: Wardeh
authors.forename: Christopher
authors.initials: C
authors.lastname: Nimeth
authors.forename: Raymond
authors.initials: R
authors.lastname: Tukkie
authors.forename: Susanne
authors.initials: S
authors.lastname: Trinks
authors.forename: Walter
authors.initials: W
authors.lastname: Kainz
authors.forename: Colleen
authors.initials: C
authors.lastname: Delaney
authors.forename: Gert
authors.initials: G
authors.lastname: Kaltofen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000628:therapy*; D002681:China; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D012042:Registries; D012680:Sensitivity and Specificity; D016896:Treatment Outcome