Present therapies for the treatment of atrial fibrillation (AF) are often ineffective or not well-tolerated. Atrial-based pacing reduces the development of AF in the general pacemaker population. Presently, a number of studies are exploring the role of atrial pacing for prevention of AF. This article reviews the rationale for atrial pacing as a treatment for AF and the results of recent studies evaluating atrial pacing for prevention of AF.