If it is not possible to control AFIB, either with medications or with ablation, a pacemaker may be another viable option.  In other patients, in the course of their life, scar tissue may develop in the normal cardiac electrical tissue that impedes electrical activation throughout the heart.  This can cause slowing of heart the heart rhythm that can lead to fatigue and shortness of breath in many, and more rarely to dizzy, lightheaded or passing out spells.

A pacemaker is a tiny device the size of a silver dollar, that is implanted under the skin on the chest wall with electrical leads, or wires, that are placed through an IV into a vein and passed down and into the heart. Pacemakers act as a safety net, delivering low energy pulses to the heart muscle to stimulate a beat if the heart beat slows. In some patients a special kind of pacemaker called a cardiac resynchronization device can improve cardiac efficiency in patients with Congestive Heart Failure (CHF) and abnormal electrical activation.  This “heart failure” pacemaker has been shown to improve patients symptoms of, and reduce hospitalizations for CHF.  The main risk of pacemaker placement is a small risk for infection, as it is a metal device that is placed beneath the skin.  Antibiotics given before and after device placement keep that risk of infection as low as 1%.