Pacing therapy for atrial fibrillation.

Atrial fibrillation is the most common occurring clinical arrhythmia, often resulting in cerebral embolism and a deterioration of hemodynamics. According to the Framingham study, the incidence of atrial fibrillation is 0.5% in the fifties age group and rapidly increases to 8.8% in association with aging in people in their eighties .Many therapeutic methods have been proposed for atrial fibrillation, but unlike other atrial arrhythmias, no therapeutic method has been clearly established. It is certain that the guides for treatment of atrial fibrillation are to maintain the normal sinus rhythm, and to prevent cerebral embolism. Although there is no objection to the termination of paroxysmal atrial fibrillation with drug therapy, some debatable issues remain in its preventive effect . On the other hand, cardioversion is commonly used as a non-drug therapy, but the recurrence rate is very high even if it is successful. It is said that when patients after cardioversion are followed up without any treatment , about half of them show recurrence within 12 months. Catheter ablation has not been abandoned in clinical research yet. Pacemaker therapy for atrial fibrillation has been preliminary performed for the purpose of improving bradycardia and improving the hemodynamics in patients with congestive heart failure. Although pacemaker therapy for the prevention of paroxysmal atrial fibrillation has not yet been established as a therapeutic method, its effectiveness is suggested and has been noticed in the results of the studies on several patients.This review summarizes current knowledge concerning the mechanism of prevention of atrial fibrillation by pacemaker therapy and the factors involved in the onset of atrial fibrillation.