Is pacemaker necessary?

  My mother (age 55, non-smoker, normal weight, in otherwise good health) has been in atrial fib off and on for two years; after two cardioversions and numerous medications, her dr has recommended a pacemaker.  However, I read above that a pacemaker will not help her condition?  I'm confused; please explain why her cardio dr would tell her to get a pacemaker?
---------------------------------------------------------------------------------------------------------------------------------
Dear Melanie:
You are correct.  A pacemaker does not directly treat atrial fibrillation.  However, a pacemaker can be useful in some cases of atrial fibrillation by allowing the cardiologist to use medications for the atrial fib that might otherwise slow the heart rate to dangerous levels.  Also, many people with atrial fibrillation have episodes when their heart rates get too low sometimes, and a pacemaker can be useful in preventing this from happening.  Thus, many patients with atrial fib end up getting a pacemaker.  In cases of extremely difficult to control atrial fib, there is procedure in which the heart's own electrical conduction sytem is disrupted and a pacemaker is placed; this is a measure of last resort and it does not sound like this is what your cardiologist has in mind.
I hope this answers your question.  I wish your mother the best of luck.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at desk F15.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.