Can You Use an AED on Someone with a Pacemaker

Can you perform CPR on a person with a pacemaker? Can an AED be used safely on someone with a pacemaker? The short answer is yes, it is generally safe to use an AED on someone with a pacemaker.

However, when treating someone who has a pacemaker with an AED and CPR, there are specific considerations that must be made. Read more to uncover some of the common misconceptions about using AEDs on pacemaker patients. 

 

Understanding Pacemakers and AEDs

When it comes to heart health, pacemakers and AEDs are two life saving devices that play crucial roles in the management of an abnormal heart rhythm and sudden cardiac arrest. Knowing the difference between these two devices is essential to understanding how they can be used safely and effectively together during an emergency if needed

What is a Pacemaker?

A pacemaker is a small device that can be surgically inserted into a person’s chest. It helps to regulate an abnormal heart rhythm through an internal shock. The device is typically placed beneath the left clavicle and connected to the heart through a vein in the left arm. Its primary function is to help regulate the heartbeat, particularly in those who have a slow heartbeat. This small device delivers low-energy electrical pulses to encourage the heart to beat at a regular rate.

Pacemakers can help manage two types of arrhythmias: tachycardia (heart rate exceeds the normal range) and bradycardia (heart rate is too slow). When a person’s heart rate deviates from its normal heart rhythm, the pacemaker is designed to detect this and send an electrical signal to the heart to regulate it back to its normal rate.

What is an AED?

An AED, or automated external defibrillator, is a medical device used to provide an electrical shock to the heart in cases of sudden cardiac arrest. The purpose of defibrillation is to shock the heart back into a normal rhythm when a person is experiencing a life-threatening abnormal heart rhythm, such as ventricular fibrillation, thus reducing the risk of sudden cardiac death. 

AEDs are designed to be used by anyone, even those without medical training, as they come with audio instructions that guide the user through the process.

Pacemaker and AED Interactions

While pacemakers and AEDs serve different purposes, they both revolve around the heart’s rhythm and can intervene with each other during a cardiac emergency. Many mistake this small device as a sign that automated external defibrillators can not be used. 

However, even individuals who have a pacemaker need to be attended to with an AED during a cardiac emergency. The key is to be sure the AED does not interfere with the pacemaker.  

Using an AED on a Pacemaker Patient

Using an AED on someone with a pacemaker is generally safe, but it is essential to follow specific guidelines to ensure the person’s safety and the effectiveness of the AED. This includes appropriately identifying a person with a pacemaker, placing the AED pads correctly, and understanding how CPR and pacemakers interact.

Identifying a Person with a Pacemaker

One way to identify a person with an implanted pacemaker is through a medical alert bracelet, necklace, or pacemaker ID card, which may indicate the device’s presence. Be sure to check the victim’s arms, neck, and pockets/wallet for these indicators if you suspect they have a pacemaker.

Another clue might be a small bump just below the collarbone. Checking both the left and right side of the chest for a small bump or scar from the pacemaker implantation surgery will help

*Caution: An implantable cardioverter defibrillator (ICD), which delivers a high shock much like an AED, may have a similar appearance. Seek medical professional help, if possible to help detect which one it is. Typically, the implantable cardioverter defibrillator will be slightly larger.

Proper AED Placement for Pacemaker Victims

Responding to sudden cardiac arrest in pacemaker patients requires quick thinking and decisive action. If the individual is unresponsive and not breathing, it is crucial to administer CPR promptly. This involves chest compressions and rescue breaths to maintain blood flow and oxygen supply to the brain and other vital organs.

In addition to CPR, if an AED is available, it should be applied immediately. Properly placing the electrode pads is crucial to avoid electrical impulse interference with the pacemaker’s function.

Each pad can be placed as normal- one electrode pad on the upper right chest and the other electrode pad just below the chest on the left side. Manufacturers recommend positioning the pads at least one inch away from the pacemaker device. 

Follow the voice prompts provided by the AED to deliver a shock if necessary. If the person’s heart rhythm returns to a normal heartbeat, the AED will not deliver a shock. Continue to perform CPR with chest compressions and use the AED as directed until medical professionals in an ambulance arrive.

CPR and Pacemakers: What You Need to Know

It is a common misconception that CPR cannot be performed on someone with a pacemaker. In reality, CPR can be administered to a person with a pacemaker, as the device is typically located on the far left or right sides of the patient’s chest, away from the center of the chest where compressions are performed.

CPR should not be administered directly over the pacemaker, as this could cause damage to the device or harm the patient. Always follow the latest CPR guidelines and be familiar with the differences between pacemakers and defibrillators when responding to a cardiac emergency.

 

Frequently Asked Questions

Q. Can an AED be used on someone with a pacemaker or an Implantable Cardioverter Defibrillator (ICD)? 

A. Yes, an AED can be safely used on someone with a pacemaker or implantable cardioverter defibrillator that is experiencing sudden cardiac arrest. Be sure to place the AED pads at least one inch away from the device and follow the AED’s voice prompts to deliver a shock if necessary. An AED will not deliver a shock if a pacemaker or ICD has already restored the heart back to a normal rhythm. 

Q. Where do you place AED pads on victims with pacemakers?

A. When using an AED on someone with a pacemaker or implantable cardioverter defibrillator, it is important to take extra caution by making sure the AED pads are placed at least one inch away from the internal device. This will help ensure the individual’s safety while still giving the opportunity to use the AED to save the person’s life.

Q. When should an AED not be used?

A. AEDs should not be used when a victim is conscious, breathing, or has a pulse. They also should not be used if the victim is in the water or on a wet surface. The same goes for metal surfaces or areas around conductive materials, as there is a risk that the electric shock from the AED could spread to the rescuer or cause other harm. 

Q. Can CPR be done on a person with a pacemaker? 

A. Yes, CPR can be performed on a person with an implanted pacemaker as long as compressions are not administered directly over the pacemaker. The device is typically located on the far left or right sides of the chest, away from the center of the chest, where compressions are performed.

Q. What are 4 things to be avoided if you have a pacemaker device?

A. It is essential to avoid the following items that can interfere with the functioning of a pacemaker:

• Metal detectors
• Strong magnets
• Devices that generate strong electrical fields, such as industrial X-ray machines or unshielded MRI units

To protect your pacemaker, it is recommended not to wear jewelry with ferromagnetic components near the pacemaker device and avoid contact sports or activities where there is a risk of trauma to the chest area.