REmodeling the Left Ventricle With Atrial Modulated Pacing (REVAMP)

Inclusion Criteria:

• Subject has had a market released dual chamber Medtronic Pacemaker with a Sleep function for at least 3 months
• Subject is stable on current medications
• Subject has dyspnea with exertion or diagnosed as NYHA Class II or III Heart Failure
• Subject has had a prior Echo in past 6 months with: EF ≥ 50% and Diastolic volume <80 ml/m²
• Subject has evidence of hypertrophy (indexed to body surface area: men 115 g/m², women 95 g/m² or indexed to height: men 49.2 g/m2.7, women 46.7 g/m2.7) or Relative Wall thickness >0.42, or Wall Thickness>1.2cm (posterior wall)
• Subject is willing to sign and date the study Informed Consent Form (IC Form) - Subject is 18 years of age or older, or of legal age to give informed consent per local law
• Subject is expected to remain available for follow-up visits

Exclusion Criteria:

• Subject has permanent AF or AF noted on baseline interrogation rhythm strip
• Subject has uncontrolled BP; (systolic pressure needs to be >100mmHg and <160mmHg on medications)
• Subject has severe stenosis of the aortic or mitral valve, defined as valve area ≤1.0 cm² or severe regurgitation of the aortic or mitral valve
• Subject has symptomatic Chronic Obstructive Pulmonary Disease (COPD) requiring oxygen
• Subject's Pacemaker has less than 6 months of Pacemaker battery life
• Subject had an aortic valve replacement (surgical or TAVR) procedure less than 9 months prior to enrollment
• Subject's programmed upper rate limit is less than 100 bpm because of concerns of elevated pacing
• Subject is unable or unwilling to perform the 6 Minute Walk Test at all scheduled study visits
• Subject is currently enrolled or planning to enroll in a potentially confounding trial during the course of the study (co-enrollment in concurrent studies is only allowed when documented pre-approval is obtained from the Medtronic study manager)
• Subject is pregnant
• Subject meets any exclusion criteria required by local law
• Subject's life expectancy is less than 12 weeks
• Subject with medical condition that precludes the patient from participation in the opinion of the investigator
• Subject has known coronary disease with Class II angina