This is a revision of an earlier posting on this subject, redone and reposted because I believe this is an important topic about which very little seems to be said.
In the first 4 years of living with a cardiac pacemaker (PM) implanted, the following instances of misinformation,lack of proper oversight,delayed reports and/or misdiagnosis occurred.I did not need that stress after having a titanium foreign body containing a 3 V battery crammed under my left chest wall muscle attached to wires going to various parts of my heart which was quite enough to ramp up my anxiety level to at least sub-panic attack levels.
1)In October 2015 I had a pacemaker implanted- one which is designed for bi-ventricular pacing the most common form of CRT (cardiac resynchronization therapy).This has 3 leads, right atrium,right ventricle (actually mine is in the His Bundle position) and a Left ventricular lead (in a vein along the wall of the left ventricle)
2)The technician who assisted and provided technical advice to the EP cardiologist at the time of the implantation told me on the following day that my home -bedside PM communication device would send a recording every night to the manufacturer's web site and then to the hospital PM center.
Only 6 months later was I informed by him , in reply to a question from me, that no -that was not true and that arrangement was only for devices with a defibrillator which I did not have. So for six months I made a effort to be near near by communication device device each night that in fact did nothing at all.
2.In October of 2016 my device recorded several episodes designed as AF/AT (atrial fibrillation/atrial tachycardia) Episodes of AF are thought to be common ( at least 30% by three years in patients with a PM- according to one data base).This lead to to my fairly extensive literature review of the issue of AHRE ( atria high rate episode). I learned that the topic is controversial and opinion varies as to what if any threshold there is for "signficiant volume of AF" to justify anticoagulation. (There are 2 randomized clinical trials underway that are designed to try and answer that question)
Also, All AHREs so designated by the PM's algorithms are not in fact AF. The phenomenon of far field r wave sensing and and a less common and more obscure PM rhythm disturbance known as recurrent, non reentrant ventricular atrial synchrony (RNRVAS) are capable of mimicking AF.The technician at the hospital PM center who is tasked with screening the remote interrogation report had not recognized that the rhythm was FFA and apparently did not feel that the issue required calling the matter to the attention of the EP cardiologist.