What is an Atrial Fibrillation Pacemaker?

Lisa Cox

An atrial fibrillation pacemaker is an implantable device used to control an arrhythmia of the heart. Atrial fibrillation occurs when one chamber of the heart, the atria, quivers instead of beating like it should. Symptoms of an irregular heart beat can include fatigue, dizziness, and chest pains. Putting in a pacemaker to correct this problem is considered a last resort.

Patients with atrial fibrillation have an abnormal heart rate.
Patients with atrial fibrillation have an abnormal heart rate.

Physicians worry about atrial fibrillation because it raises the risk of stroke in affected patients. Atrial fibrillation treatment usually starts with prescription medications, including blood thinners that help clots from forming. Drugs that will help control the heart rhythm can also be used. That works well for many patients who have intermittent atrial fibrillation.

Patients who experience irregularities in their heart rhythm may need the assistance of a pacemaker.
Patients who experience irregularities in their heart rhythm may need the assistance of a pacemaker.

When a patient has other heart problems, such as heart failure, heart attack, or low blood pressure, he can become unstable and need immediate intervention. To quickly restore a normal rhythm, a physician can use cardioversion, which applies an electric current to the heart to shock it back into rhythm. When the patient isn't in a medical setting, cardioversion isn't likely to come quickly enough. That's where a pacemaker comes in.

Paroxysmal atrial fibrillation is a brief episode of intense fibrillation, often followed by a slower than normal heart rate. This is often magnified by the drugs given to control atrial fibrillation, which slow heart rate even further. In this case, and in the case of acute and ongoing atrial fibrillation that does not respond to drugs, a pacemaker may be needed.

Certain patients with uncontrolled atrial fibrillation may need a procedure called an ablation. An ablation destroys the electric path causing the atrial fibrillation. This requires a pacemaker to keep the heart beating correctly. This is done as a last resort and is not common. Permanent pacemakers need to be monitored and require periodic adjustments, including surgery to replace batteries.

In what is considered minor surgery, a permanent pacemaker is implanted surgically in the chest wall, just under the skin. It is usually about the size of a deck of cards or smaller. Small wires with electrodes are threaded into the heart to apply electrical stimulation to specific parts of the heart. This can override the atrial fibrillation and help restore a normal heart beat. It takes an hour or less for a surgeon to implant a pacemaker, recovery time is minimal, and patients normally leave the hospital in a day or two.

There are disadvantages of an atrial fibrillation pacemaker. Atrial fibrillation pacemaker complications caused by the surgery can include a puncture to the heart, bleeding, and infection. Patients with a pacemaker cannot undergo magnetic resonance imaging (MRI) because it could affect their pacemaker. Pacemakers can also set off metal detectors, so patients often carry an identification card they can show to prove they have a pacemaker.

It is important for patients to talk to a cardiologist about atrial fibrillation. Having a stroke can be debilitating or life threatening. There is no way to predict whether patients with atrial fibrillation will have a stroke. In addition, uncontrolled atrial fibrillation can be related to other heart conditions. If medication does not bring the condition under control, the only real way physicians have to control get control of the problem is with an atrial fibrillation pacemaker.

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