Pacing for the prevention of atrial fibrillation

Nonpharmacological methods are being evaluated for the prevention of atrial fibrillation. The role of atrial pacing has been extensively examined in a large number of retrospective and prospective studies, and recently in randomized multicenter trials. The populations examined have varied from patients with sick sinus syndrome with incidental AF, to patients with drug refractory AF. In addition to standard atrial pacing from the high right atrium, pacing from novel sites like the interatrial septum, Bachman bundle, and dual-site or biatrial pacing have been employed for the prevention of AF. This review discusses the current status of different single-site pacing and dual-site pacing modes for the prevention of AF. It also discusses the mechanism of prevention of AF with these modes and the future directions these modes may take.