This article reviews the wide range of implantable device-based therapies (mainly pacemakers) that are being used in the management of atrial fibrillation (AF), atrial flutter, and atrial tachycardia. The role of pacemakers in the management of patients with AF and in the prevention of AF has been extensively studied. Based on well-designed prospective clinical trials, only a few of these strategies can be recommended for routine clinical use in related subpopulations.