John Fetterman got a pacemaker and defibrillator following stroke

Lt. Gov. John Fetterman, who has been in the hospital recovering from a stroke since Friday, got a pacemaker with a defibrillator implanted Tuesday afternoon, his campaign said.

”John Fetterman is about to undergo a standard procedure to implant a pacemaker with a defibrillator. It should be a short procedure that will help protect his heart and address the underlying cause of his stroke, atrial fibrillation,” the campaign said.

The campaign later said Fetterman, the winner in Pennsylvania’s Senate Democratic primary Tuesday, was told the procedure was successful.

“He is resting at the hospital and recovering well,” a spokesperson said Tuesday evening. “John continues to improve every day, and he is still on track for a full recovery.”

The campaign has said doctors treated Fetterman’s stroke in time to prevent any cognitive damage, performing a procedure to remove a blood clot from his brain.

But a defibrillator is designed to treat a different problem: sudden cardiac arrest. The fact that Fetterman is getting such a device in his chest, combined with a pacemaker, could suggest that his heart problems go beyond atrial fibrillation, physicians not involved with his care say.

» READ MORE: Here’s what we know about John Fetterman’s stroke — and long-term recovery for patients like him

The campaign has not responded to requests to talk to Fetterman’s doctors.

Defibrillators are a miniature version of the “paddles” used in emergency rooms, designed to deliver an electric shock that reboots the heart in the event of cardiac arrest.

Cardiac arrest can result from a variety of heart conditions, but not atrial fibrillation, said Michael Savage, professor of cardiology at Thomas Jefferson University.

”Atrial fibrillation in and of itself isn’t really a risk for cardiac arrest,” he said. “A defibrillator takes us to a whole other level of what is his underlying problem.”

It’s possible that Fetterman was diagnosed with a type of cardiomyopathy — characterized by a weakened heart muscle — which in turn could result in both atrial fibrillation and increased risk of sudden cardiac arrest, Savage said.

People who get defibrillators can live for many years without incident.

From the details provided by the campaign, it was not clear what Fetterman’s doctors hope to achieve with the pacemaker. All defibrillators come with pacemakers, as they are needed to “pace” the heart after it is shocked back into normal rhythm.

But a pacemaker also may be needed in Fetterman’s case to regulate his heart rate on a day-to-day basis, Savage said.

Atrial fibrillation (”a-fib”), the condition that led to Fetterman’s stroke, is a type of irregular rhythm. But pacemakers are used to increase a heart rate that is too slow, whereas with a-fib, the heart is beating too fast. It could be Fetterman has a condition in which his heart beats too fast while it’s in a state of atrial fibrillation, yet too slowly the rest of the time, Savage said.

Fetterman voted via emergency absentee ballot Tuesday and is expected to remain in the hospital for several days.

His wife, Gisele, was expected to attend an election-night rally in Pittsburgh.

» READ MORE: John Fetterman suffered a stroke just days before Pa. Senate primary but says he’s recovering well

Earlier Tuesday, Gisele Fetterman told reporters outside her polling place in Braddock that her husband was recovering well and “impatient,” but in good spirits.

She said the experience has her eager to talk about strokes and the signs to watch for, along with the lack of access to emergency medical care for many in the state.

“We were lucky that we were in a location … we were very close to a stroke center, one of the best in the state. We should be talking about parts of the state that are rural areas, that would not have had the same access and the same intervention that he would have had.”

One of Fetterman’s opponents, U.S. Rep. Conor Lamb, said outside a polling place in Squirrel Hill that voters brought it up to him Tuesday at the polls. “Nobody knows what’s going on and each new disclosure seems like a surprise,” he said.

But he said that without more information, he was hesitant to weigh in.

“And one of the reasons that I don’t, and no one has all the facts of the situation, is not many have been disclosed and so that is up to you all to determine what the truth is and when it should have come out ... but I do know it’s the kind of question I’ve heard. ... It does seem like the kind of thing people would want to know before they vote.”