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Question: would you treat atrial fibrillation if a patient is on dual chamber pace maker? is there a need to start anticoagulation in this case? what is the risk of cardioembolic stroke in these patients?
Answer: Anticoagulation is very important. There are other medications besides coumadin. But Even with a dual pacer, a person can still go into afib, or have rhythms that can cause an embolic event. I do not know what the actual statistics are, but I do know that it is a standard to place a person on anticoagulation with afib. (right now I have a pt on a dual pacer, and she STILL has persistent afib without even feeling it. ) a pacer can speed up to help bring the heart rate down, it can pace the heart to hopefully assume a normalized beat, and it can shock a person out of a dangerous rytymn. But in the meantime, if the person goes into afib, the risks for clots getting thrown off of a valve increase tremendously.
