While pacemakers help treat arrhythmia, they don’t prevent heart attacks. Heart attacks can be difficult to diagnose in people with pacemakers, potentially leading to treatment delays. Call emergency services if you suspect you’re having a heart attack.

It is estimated that up to 3 million people in the United States have a pacemaker. This implanted device uses small electrical impulses to help your heart beat at a natural rhythm and rate.

Pacemakers help treat a type of heart disease called arrhythmia. This is when your heart beats too fast, too slow, or irregularly.

A heart attack is a medical emergency that happens when the blood flow to your heart is blocked. This can cause your heart tissue to become damaged and die. Roughly 805,000 people in the United States have a heart attack each year.

Although pacemakers are a treatment for heart disease, people who have them can still have a heart attack. Keep reading as we explore this topic in more detail.

People with pacemakers can have a heart attack. However, for many years, it’s been a common misconception that pacemakers protect against heart attacks.

While a pacemaker can treat arrhythmia and prevent its complications, it does not protect against blockages in your heart’s blood vessels that lead to heart attacks.

Coronary artery disease (CAD) causes most heart attacks. CAD is a common condition, affecting about 1 in 20 adults in the United States over the age of 20 years.

In CAD, plaque builds up on the walls of the heart’s arteries, causing them to become narrower. If an artery becomes blocked due to a blood clot, oxygen-rich blood can no longer reach the heart tissue, and a heart attack occurs.

Conversely, a heart attack can lead to the need for a pacemaker. This is because the damage from a heart attack can lead to arrhythmia.

The signs and symptoms of a heart attack with a pacemaker are similar to those in people without a pacemaker. They can include:

A heart attack is a medical emergency.

Medical emergency

Call emergency medical services or have someone take you to the nearest emergency room if you experience the following warning signs of a heart attack:

  • chest pain or discomfort that lasts longer than a few minutes or that goes away and comes back
  • lightheadedness, nausea, or vomiting
  • pain in your jaw, neck, or back
  • pain or discomfort in your arm or shoulder
  • shortness of breath

Heart attacks with a pacemaker can be difficult to diagnose initially. This is because of the way doctors typically diagnose heart attacks.

An electrocardiogram (ECG) is often the first test that’s done when doctors suspect a heart attack. An ECG measures the electrical activity of your heart as it beats. This electrical activity is translated to a wave pattern. A doctor can view this wave pattern to determine that the electrical activity in your heart is optimal. Irregularities in this pattern can indicate a problem with your heart, such as a heart attack.

A pacemaker is designed to deliver regular electrical impulses to keep your heart beating at a natural rhythm and rate. Due to this, the ECG readings of people with a pacemaker may not as readily show that they’re having a heart attack.

Experts propose various ECG criteria to help better diagnose heart attacks in people with a pacemaker. Doctors may use other tests to diagnose heart attacks. These include blood tests for cardiac markers like troponin and creatinine kinase and heart imaging techniques, such as:

Doctors treat a heart attack in someone with a pacemaker in the same way as in someone without a pacemaker.

If you suspect a heart attack, doctors opt for emergency treatment early. This can include:

The main treatment for a heart attack is percutaneous coronary intervention (PCI). During PCI, a doctor guides a catheter to your heart and uses a balloon-like attachment to open the blocked blood vessel. They often place a stent.

If the diagnosis is delayed, people with a pacemaker who are having a heart attack may have a less favorable outlook. Researchers found that the time between arriving at the hospital and receiving a PCI is delayed in people with a pacemaker.

In some cases, a severe heart attack can also affect the function of a pacemaker. If scar tissue from a heart attack forms at the area of one of the pacemaker’s leads, the pacemaker may not be able to effectively deliver electrical impulses to the heart.

Keep reading below for more answers to questions about heart issues and pacemakers.

Can cardiac arrests happen with a pacemaker?

Yes, people with pacemakers can still experience cardiac arrest. If you have life threatening arrhythmia, then that could lead to cardiac arrest. You may have an implantable cardioverter defibrillator (ICD) instead to avoid this.

An ICD keeps track of your heart rate and helps restore your usual heart rate if arrhythmia occurs. Many ICDs also have a pacemaker function.

How can you tell if something is wrong with your pacemaker?

Contact your doctor immediately if you think your pacemaker isn’t working. Some signs that there may be something wrong with your pacemaker, if you:

  • notice your heart beating quickly or slowly
  • have hiccups that won’t go away
  • find that you’re extremely fatigued
  • are short of breath
  • feel dizzy or lightheaded
  • have had fainting spells

Can a pacemaker detect a heart attack?

No, a pacemaker cannot detect a heart attack. If you have a pacemaker and suspect you’re having a heart attack, call emergency medical services.

You can still have a heart attack if you have a pacemaker. This is because a pacemaker does not treat or prevent the blockages in your heart’s blood vessels that lead to a heart attack.

Heart attacks in people with pacemakers may be difficult to diagnose in some cases. This can lead to a delay in treatment and a less favorable outlook. It’s also possible for a heart attack to affect pacemaker function.