TRENDS: A Prospective Study of the Clinical Significance of Atrial Arrhythmias Detected by Implanted Device Diagnostics

Inclusion Criteria: * Subject provides written informed consent and privacy/protection authorization. * Subjects 65 years of age or older. OR * Subjects with age \>18 and \< 65 years and one of the following stroke risk factors: * Prior stroke or TIA * Diagnosis of hypertension (HTN) * Diagnosis of Diabetes Mellitus (DM) * Diagnosis of Congestive Heart Failure (CHF) * Subjects who meet the Class I/Class II indications for a dual chamber implantable pulse generator or dual chamber implanted cardioverter defibrillator device OR • Subjects who meet the criteria for indication of a dual chamber resynchronization device with bi-ventricular pacing (moderate to severe CHF symptoms \[NYHA Class III-IV\] despite optimal medical therapy, left ventricular ejection fraction ≤ 35%, and a QRS duration ≥130 ms)13. Exclusion Criteria: * Subjects who are to receive a replacement IPG, ICD or CRT device. * Subjects with chronic (permanent) AT/AF. * Subjects with a history of AV nodal dependent arrhythmias. * Subjects with a terminal illness who are not expected to survive more than 6 months. * Subjects who are unwilling or unable to cooperate or give written informed consent and privacy/protection authorization, or subjects whose legal representatives or legal guardians refuse to give informed consent or privacy/protection authorization. * Subjects currently receiving treatment in another drug and/or device study which could affect the outcome of the trial. * Subjects who are or will be inaccessible for follow-up at a qualified study center.