How Do Pacemakers Help Prevent Atrial Fibrillation?

— -- Question: How do pacemakers help prevent atrial fibrillation?

Answer :There was a lot of hope a number of years ago that pacemakers would prove to be an effective treatment for atrial fibrillation. But in fact they're very ineffective, and they do not treat atrial fibrillation.

There's only one situation where pacemakers play an important role in patients with atrial fibrillation, and that is in patients who have both atrial fibrillation and they have slow heart rhythms. That's a condition that's referred to as tachy-brady syndrome.

So there are some patients that will go into atrial fibrillation for a period of time. The atrial fibrillation will stop and then their underlying heart rate is extremely slow. And in those patients, it makes sense to put in a pacemaker because for two reasons. One, that will normalize the heart rhythm. And two, in the setting of this A fib and a slow heart rhythm, putting in a pacemaker may reduce the amount of atrial fibrillation you're having. But more importantly, the presence of a pacemaker will allow your doctor to put you on anti-arrhythmic medications safely.

If you have a tendency for a very slow heart rhythm, if you were placed on and anti-arrhythmic medication, your heart rate may get so slow you could get dizzy or pass out. So pacemakers are really used to allow your doctor to put you on an anti-arrhytmic medication.

But I think it's important to realize that pacemakers are not an effective treatment for atrial fibrillation, but many patients with atrial fibrillation have a pacemaker to allow your doctor to put you on medications.