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Pittsburgh Post-Gazette: What to know about pacemakers and defibrillators

After suffering a stroke on Sunday, Lt. Gov. John Fetterman underwent a “standard procedure” on Tuesday to receive a pacemaker with a defibrillator, according to his campaign.

The device is intended to address his atrial fibrillation, the underlying cause of his stroke, by regulating his heart rate and rhythm. Atrial fibrillation is an irregular, quivering or fast heartbeat.

Mr. Fetterman, 52, had said previously that his stroke “was caused by a clot from my heart being in an [atrial fibrillation] rhythm for too long.” He was being treated at Penn Medicine Lancaster General Health.

Dr. Jeffrey Liu, a cardiologist and director of electrophysiology at St. Clair Hospital, spoke with the Pittsburgh Post-Gazette about what the procedure involves. (This interview has been edited for length and clarity.)

Post-Gazette: What is a pacemaker?

Dr. Liu: A pacemaker is a device that’s meant for people who have heart rates that are too slow. The pacemaker is a device that is surgically implanted where the wires go into the heart, and essentially, these wires in the pacemaker itself are designed to stimulate the heart to squeeze such that the heart rate will not drop below whatever rate we program the pacemaker at.

What’s the difference between a pacemaker and a defibrillator?

Defibrillator devices are distinctly different from pacemakers. Defibrillator devices can function as a pacemaker — they will stimulate the heart to squeeze — but they also have a very important and additional feature. In addition to potentially treating any slow heart rate, defibrillators are also designed to treat fast heart rates. The way that we treat fast heart rhythm is by delivering an electrical shock, and defibrillators are devices that will monitor for life-threatening fast heart rhythms that ultimately deliver a shock to restore a normal heart rhythm.

How common is it for somebody in their 50s to need a pacemaker or defibrillator?

Pacemakers and defibrillators are often implanted in people who are a little bit older, but it’s not out of the ordinary for a 50-year-old to have one, either due to a heart rate that’s too slow or an abnormal heart rhythm. They’re placed on medications that are designed to treat these cardiac conditions. Sometimes these medicines can also slow the heart rate down too much and a defibrillator is needed to help fix a slow heart rate that may be caused by the medications.

How long do pacemakers and defibrillators usually last?

The battery life of these devices typically lasts anywhere between eight to 12 years. When the battery is at the end of its road, we essentially take the whole device out. If the wires that are connected to the device inside the heart are still working appropriately, they are left intact and reused and a new device is hooked up to those wires.

Can people who get a pacemaker or defibrillator go on to live a relatively normal life?

Absolutely. People are usually able to return to a very normal lifestyle without any profound functional limitations.

How long does it take to recover from getting a pacemaker or defibrillator implanted?

It’s a relatively minor procedure. The procedure itself usually only takes an hour or two. After the procedure, the recovery is typically pretty quick. Often, patients are discharged the same day or stay for a one-night observation. When we place pacemakers and defibrillators, we place them under the skin on either the left or the right chest. So in terms of restrictions, we may ask patients to limit what they do with their arms. For example, if we put a pacemaker on the left side, we ask patients not to lift anything overly heavy or flail the left arm around over the head.

 

Emily Mullin: [email protected]

First Published May 17, 2022, 9:21pm