I wonder if people are confusing implantable cardioverter defibrillators (ICD) with cardiac pacemakers (PPM). ICD can usually pace as well. ICD are for treating ventricular fibrillation (VF) rather than atrial fibrillation (AF) (although having atrial fibrillation increases your risk of ventricular fibrillation if you have heart failure). Pacemakers can reduce risk of VF, which increases if the heart rate is too slow, but pacemakers are primarily for slow heart beats or where the heart may stop. People with AF may have a slow heart beat and may need a pacemaker. Pacemakers can also help heart failure - resynchronisation therapy.