An Automated External Defibrillator (AED) is a portable device that delivers an electrical shock to the heart during sudden cardiac arrest, aiming to restore a normal rhythm. Many individuals live with pacemakers, small implanted devices that regulate heart activity. A common concern is the compatibility of these two technologies. This article addresses whether an AED can be safely used on someone with a pacemaker.
Understanding Pacemakers and AEDs
A pacemaker is a small, battery-powered device surgically placed under the skin, typically near the collarbone. It uses thin, insulated wires, called leads, which are threaded through veins into the heart chambers. The pacemaker continuously monitors the heart’s electrical signals and delivers precisely timed, low-energy electrical pulses to stimulate the heart muscle when it beats too slowly or irregularly.
An Automated External Defibrillator (AED) is a medical device designed for public use, capable of analyzing the heart’s rhythm and, if necessary, delivering an electrical shock. This high-energy shock, known as defibrillation, aims to stop chaotic electrical activity, such as ventricular fibrillation, allowing the heart’s natural pacemaker to resume a normal, organized rhythm. AEDs are equipped with voice prompts and visual cues to guide rescuers through the process.
Safe AED Use with a Pacemaker
Using an AED on someone with a pacemaker is safe and recommended during sudden cardiac arrest. The primary concern is not the electrical shock itself, which modern AEDs deliver safely, but the direct placement of AED pads over the pacemaker device. Directly placing a pad over the pacemaker could damage the device or interfere with its function due to concentrated electrical energy.
To avoid this, observe the person’s upper chest for a small bulge under the skin, indicating the pacemaker’s location. When applying AED pads, position them at least one inch away from this bulge. If standard pad placement (upper right chest and lower left rib cage) would place a pad directly over the pacemaker, adjust the pad’s position slightly to the side.
Alternatively, an anterior-posterior pad placement may be used, with one pad on the front of the chest over the left lower rib cage and the other on the person’s back, between the shoulder blades. Always follow the voice and visual prompts provided by the AED. The device will analyze the heart rhythm and only advise a shock if it detects a shockable rhythm, regardless of a pacemaker’s presence.
Post-AED Medical Care
Following AED use on an individual with a pacemaker, immediate professional medical attention is crucial, even if consciousness is regained. Emergency medical services (EMS) should be contacted promptly, as they provide advanced life support and transport to a hospital. Healthcare professionals will assess the person’s condition and the pacemaker’s functionality.
A cardiologist or other medical personnel will perform tests to ensure the pacemaker operates correctly after receiving an electrical shock. This evaluation confirms the device was not damaged and continues to deliver appropriate therapy. Addressing the underlying cause of the cardiac arrest is also important for medical teams to prevent future episodes and improve long-term health.