Certain types of pacemakers were considered for prevention of atrial fibrillation. Multisite atrial pacing was initially thought to reduce the chance of atrial fibrillation. There were pacemakers with special programs for prevention of atrial fibrillation. But later studies did not show much advantage.
In addition to this, a pacemaker can pace the heart when the heart is unduly slowed by beta blockers which are commonly used to control fast heart rate in atrial fibrillation. This helps in optimizing the dose of beta blockers and similar drugs used for treatment of atrial fibrillation without the fear of undue slowing of the heart.
Another situation in which pacemaker is used in atrial fibrillation is after ablation of the AV node. When heart rate in atrial fibrillation cannot be controlled adequately by medications, radiofrequency energy delivered through an electrode is used to ablate the atrioventricular node, which passes the atrial signals to the ventricles. This produces block at the AV node. Then a pacemaker is needed to maintain the heart rate by pacing the ventricles.
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