Abstract
Atrial fibrillation (AF) is by far the most common form of sustained cardiac arrhythmia. Primary and secondary prevention of AF is an important clinical goal. The idea of preventing recurrence of AF by different location of the lead(s) and different modes and/or algorithms of pacing has been under evaluation for the last decade. The ability of pacing mode to affect the occurrence of AF was first noted from observational studies [1,2]. During the past several years it was confirmed in four randomized pacing trials [3]. Recent large trials of rhythm control versus rate control in AF - such as the Pharmacological Intervention in Atrial Fibrillation (PIAF) [4], AF Follow-up Investigation in Rhythm Management (AFFIRM)[5], and Rate Control vs Electrical Cardioversion for Persistent Atrial Fibrillation (RACE) trials [6] - suggest that suppression of AF has no effect on the traditional hard outcomes like stroke and cardiovascular death. Reduced frequency and duration of AF, however, is still an important clinical goal in patients with symptomatic AF. The aim of this paper is to review the accumulated data on the pacing algorithms for secondary prevention of AF.
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