Objective: To explore the clinical application and significance of permanent pacemaker program control in the diagnosis of atrial fibrillation. Methods: Seventy-eight patients with atrial fibrillation admitted to our hospital were randomly divided into program-controlled group and non-program-controlled group. The observation group was given permanent pacemaker program-controlled diagnosis, and the non-program-controlled group was implanted permanent pacemaker, but not program-controlled. The basic information, atrial fibrillation load, atrial and ventricular pacing ratio, atrial structural remodeling, left heart function and P wave results of the two groups were compared and analyzed. To compare the difference between permanent pacemaker programmed diagnosis and clinical diagnosis and analyze the sensitivity of permanent pacemaker programmed diagnosis in atrial fibrillation. Results: There were no significant differences in the ratio of male to female, age, types of arrhythmia, existing underlying diseases and used therapeutic drugs between the program control group and the non-program control group(P>0.05). The af load, VP value and minimum time of P wave in programmed group and non-programmed group were significantly lower than those in non-programmed group, while AP value, maximum time of P wave and P wave dispersion were significantly higher than those in non-programmed group(P<0.05).There were no significant differences in LAD, RAD, LVEDD and LVEF values between programmed group and non-programmed group before and after implantation(P>0.05). Compared with clinical diagnosis results, it was found that the detection rate of atrial fibrillation by permanent pacemaker program control was 97.44 %, and the sensitivity of the diagnosis of atrial fibrillation by permanent pacemaker program control was 98.72 %. Conclusion: In the diagnosis of atrial fibrillation patients, permanent pacemaker program control can give accurate judgment on the results of ecg examination, which has high clinical application value and is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]