[No evidence of positive effects of pacemaker use in paroxysmal atrial fibrillation]

Sixteen randomised controlled studies examining the use of pacemakers for the therapeutic prevention of atrial fibrillation were investigated. Four studies dealt with patients without conventional pacemaker indication. A minor positive effect was observed in one study. The validity of the observation is however limited due to a small number of patients and a short follow-up period. Five studies assessed the effect of overdrive pacing and different preventive pacing algorithms. A small, statistically significant positive effect was found in one of these studies. Six studies investigated dual site pacing or septal pacing. Five of these indicated a possible positive effect. Before this approach is implemented clinically, further studies are nevertheless required.