The role of devices that deliver shock therapy for atrial fibrillation is still debated, Following technical improvements in catheter-based atrial defibrillation, implantable devices have become available either in the form of stand-alone atrial defibrillators or in the form of dual defibrillators. Although preliminary results do not support their use as a single, unique treatment for atrial fibrillation patients, in combination with drugs, pacing or other treatments such as ablation, atrial defibrillators should help appropriately selected groups of patients. Curr Opin Cardiol 2002, 17:82-89 (C) 2002 Lippincott Williams Wilkins, Inc.