Atrial fibrillation (AF) is a common clinical arrhythmia with significant symptomatology and is associated with an increased risk of systemic embolic events. Until recently, the treatment options for AF were essentially pharmacological. Recent developments in the understanding of the mechanisms of AF have resulted in a series of non-pharmacological treatments becoming available. Such treatments include surgical 'maze' procedures and, more recently, the introduction of radiofrequency ablation techniques within the atria to prevent fibrillation. Complex pacing procedures, including multisite and biatrial pacing, have been used to treat AF. Tailoring treatment for individual patients is a complex task and this review will attempt to rationalise the non-pharmacological treatment paths for individual patients with AF.