It is no secret that the quick action of bystanders can save the life of someone experiencing a sudden cardiac arrest. The combination of CPR and a shock from an AED can effectively raise the survival rate of such an incident from 10 percent to 40 percent. But what if a person is fitted with a pacemaker? Can a defibrillator be used to save their life?
What is a Pacemaker?
Before you can answer whether you can use a defibrillator on someone with a pacemaker, you have to understand what a pacemaker is. A pacemaker is a small device that is placed in the chest or abdomen to control abnormal heart rhythms. During these episodes of arrhythmia, the heart can beat too fast, too slow, or erratically, causing blood to travel to the rest of the body at an unusual pace. Since the heart operates with its own electrical system that regulates heart rate, any electrical interference will also influence its operation. A pacemaker is designed to emit low-energy electrical impulses to control the heart when it experiences an arrhythmia.
Defibrillation in a Person With a Pacemaker
Since a pacemaker only administers low-energy impulses, it is not designed for times when a person begins to experience ventricular fibrillation, a condition where the heart quivers rather than beats. It is also possible for a pacemaker to malfunction, failing to deliver the lifesaving intervention. However, every AED instruction kit will say not to use an AED on a person with a pacemaker. Does this mean defibrillation is impossible?
External defibrillation may still be necessary for a person with a pacemaker. If the implanted pacemaker delivers a low-energy shock while you are attempting to use an AED or another defibrillator, you simply wait for 30 to 60 seconds for the pacemaker to complete its therapy cycle before administering the shock. While it is possible that the energy from an external defibrillator, AED or otherwise, may damage the pacemaker, these devices are designed to withstand external defibrillation.
How do you Defibrillate a Person with a Pacemaker?
It is important when using an AED or manual defibrillator on a person with a pacemaker to avoid placing the electrode pads directly over the internal device. A pacemaker looks like a round disc under the skin, usually beneath the left collarbone. As long as the defibrillator pads are placed at least one inch away, the pacemaker should be safe from damage from the electrical shock. However, if at all possible, place the electrodes as far away from the pacemaker as possible. Also, while AEDs are generally designed with one energy output setting, the standard of care for manual defibrillators is to use the lowest clinically acceptable energy output possible.
Defibrillation is necessary to save the lives of people in cardiac arrest whether they have a pacemaker or not. While the process of administering an electrical shock to someone with an internal defibrillator may seem daunting, when done with care it can effectively restore a person’s heart beat without damaging the device.