Current status of atrial pacing algorithms for the prevention of atrial fibrillation: Should algorithms be used?

Since the development of an atrial pacing algorithm for preventing atrial fibrillation (AF), approximately 20 years ago, many clinical trials have demonstrated the effectiveness of atrial pacing with respect to AF prevention. Nevertheless, the actual effectiveness of AF suppression via atrial pacing remains under debate, and no definitive conclusion has been reached. The AF suppression algorithms embedded in pacemakers have not demonstrated an unequivocal clinical efficacy that would support changing of the guidelines to recommend such algorithms. In this review of studies conducted since 2006, we discuss the efficacies of these AF suppression algorithms and their usefulness in patients requiring pacemaker implantation.