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How to Manage Atrial Fibrillation When You Have a Pacemaker 

Pacemakers normalize your heart rate and can ease atrial fibrillation symptoms

By Michele C. Hollow

If you undergo atrial fibrillation, also known as Afib, and your medication stops working, your physician may recommend a pacemaker to regulate a slow heartbeat. It's not uncommon, and the results are usually positive. Further, approximately 2.7 million Americans live with Afib, and the Center for Disease Control and Prevention expects that number to increase to 12.1 million in 2030.

A doctor monitoring the heart of a patient with atrial fibrillation. Next Avenue, Atrial Fibrillation with a pacemaker
After being diagnosed with atrial fibrillation or Afib, your doctor may recommend a pacemaker, or an atrial defibrillator. Both work to reset your heartbeat to a normal pace.  |  Credit: Getty

What is Afib? 

Afib occurs when your heart has an arrhythmia, an irregular heartbeat that beats too fast or too slow and blocks your heart from pumping enough blood to the rest of your body. In the U.S., however, the reason for a rise in Afib cases is age. (The U.S. Census Bureau notes that people older than 65 will make up 21% of the population starting in 2030.)

"It is more common in older adults," Jim Liu, a cardiologist and clinical assistant professor of internal medicine at The Ohio State University Wexner Medical Center, says. "Young people can get Afib. But unfortunately, when that happens, it's often associated with other heart conditions." 

"Young people can get Afib. But unfortunately, when that happens, it's often associated with other heart conditions."

Afib Diagnosis 

An Afib medical interpretation may involve blood clots, stroke, or heart failure, which sounds frightening. Yet, it is reassuring to learn that Afib is one of the most general conditions treated for heart arrhythmia and isn't life-threatening.  

When it comes to medical diagnosis, during Afib, your heart's "upper chambers beat irregularly and out of sync with the lower chambers," Liu says. "Your heart can feel as if it's pounding or beating too fast. As a result, you might have shortness of breath and feel weak. And some people have no symptoms." 

Treating Afib 

"Treatment for atrial fibrillation can include medications, therapy to reset your heart's rhythm, and catheter procedures to block faulty heart signals," Liu says, which is also known as cardioversion or resetting your heart's rhythm. Two types of cardioversion are performed in a hospital: electrical cardioversion (an electrical shock that resets your heart's rhythm to a normal beat) and cardioversion, wherein your doctor gives you anti-arrhythmic drugs in pill form or intravenously. 

Still, one of the most common options is cardiac ablation, which includes these three types of procedures: 

  • Catheter ablation happens when your doctor inserts a catheter through a vein and into your heart. 
  • Maze procedure occurs during open-heart surgery. 
  • A.V. node ablation is when your doctor connects your heart's upper and lower chambers with a catheter (you'd also require a pacemaker to monitor your heart and normalize its rhythm). 

First Options Other than A Pacemaker 

After learning you have Afib, your doctor will share a few different options before suggesting a pacemaker.

"Your doctor may recommend a pacemaker, or an atrial defibrillator. Both work to reset your heartbeat to a normal pace. Defibrillators are larger and can have pacemakers built in them to correct your heart's rhythm," says Liu.

Further, Liu explained a pacemaker sends electrical signals to take the place of the mixed-up heartbeats, so your heart beats at the right pace. "It's a monitor that tells your doctor what's going on in your heart; it can also stop AFib symptoms." 


The Pacemaker Route 

The pacemaker surgery is minor and requires an overnight stay in the hospital. Pacemakers are about the size of a half-dollar coin and weigh between one and two ounces. The device is placed in your chest just below your collarbone.

Below are a few tips to consider if you have a pacemaker: 

  • Take your medications 
  • Keep track of your heart rate by checking your pulse. In addition, you might want to purchase and wear an Apple watch or other smart device that monitors your heart rate. 
  • Keep pressure off your chest where the pacemaker is located 
  • Talk to your doctor about exercise and physical activity 

Pacemakers and Electronics 

Common electronic gadgets may interfere with your pacemaker. To be on the safe side of cell phones, for example, hold them on the opposite side of your pacemaker.

According to the American Heart Association, these are other electronic devices that might interfere with your pacemaker: 

  • MP3 player headphones with magnetic pieces can change your pacemaker's rhythm.  
  • Metal detectors at security checkpoints can affect your pacemaker. If you are at an airport or any other place where you have to walk through a metal detector, tell the security guards you have a pacemaker. You might want to carry a note from your physician. 

The Afib Takeaway 

"Pacemakers are not a stand-alone treatment for Afib," says Janice Johnston, chief medical officer and co-founder of Redirect Health. She adds that there are various lifestyle, diet, and health-inspired practices to consider.

  • Eat a healthy diet of fruits, vegetables, whole grains, and lean protein. 
  • Limit caffeine because coffee, black tea, sodas, and energy drinks might make your heart race. 
  • Cut back on alcohol consumption. "Too much alcohol can set off Afib symptoms," she says. 
  • Move and exercise 
  • Stop smoking 
  • Relax and meditate to ease any stress in your life 
  • Aim for eight hours of sleep each night 

Talk to your doctor about which medications you can and cannot take. Make sure all of your doctors are aware of the medications they prescribed for you. Some over-the-counter medications can cause your heart to beat faster.  The same goes for prescription drugs, decongestants, and supplements or naturopathic remedies.  

Michele C. Hollow Michele C. Hollow is a freelance writer, editor and ghostwriter specializing in health, climate, social justice, pets and travel. Follow her on Twitter at @michelechollow.   Read More
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