It’s been over a week since Lt. gov. John Fetterman celebrated his victory in the Pennsylvania Democratic Senate primary from a Lancaster hospital, where he was recovering from a stroke and the implantation of a combination defibrillator-pacemaker. However, the campaign’s explanation for his medical treatment doesn’t entirely make sense, according to cardiologists.
Fetterman’s campaign has said he is on the road to a full recovery. But while that recovery continues at his Braddock home, Fetterman himself has not publicly answered questions about his health. And his campaign has turned down multiple requests to interview his doctors without giving a reason for the refusal. It has left the full public picture of his health – and suitability for a six-year Senate term – unclear.
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With Fetterman now the Democratic nominee in one of the most competitive and consequential Senate races in the country, the unanswered questions about his health have worried some Democrats — and confused cardiologists watching on the outside.
The uncertainty stems from how Fetterman’s campaign and his wife Gisele have characterized his heart condition: a shared, irregular rhythm called atrial fibrillation (A-fib). They said the A-Fib led to his May 13 stroke, and that is indeed a common cause of stroke. But when he got the defibrillator four days later, they said the device was implanted to treat the A-fib.
But that’s not what defibrillators are for. Leading cardiologists not involved in his treatment suggest Fetterman, 52, has another heart condition that the campaign has not disclosed.
“It doesn’t make sense,” writes Anthony Pearson, a St. Louis-based cardiologist The skeptical cardiologist blog, said about the campaign’s report on Fetterman’s health.
what is Doctors say both of the procedures Fetterman underwent — removing the blood clot in his brain (the stroke) and implanting the defibrillator — are very effective when done right away. And for that, his wife perhaps deserves a lot of the credit. As the couple left a campaign rally on May 13, Gisele Fetterman said she noticed the left side of his mouth would droop briefly — a classic sign of a stroke — and insisted they rush to the hospital.
“It has no physical effects,” Gisele Fetterman said in an interview from home on Wednesday. “He feels well. He feels restless. He would like not to be here, but he doesn’t really have a choice at the moment.”
Fetterman’s medical problems began in 2017, according to the campaign, when his feet suddenly became swollen — a possible sign of A-fib. He went to a hospital for tests and doctors diagnosed him with an irregular heart rhythm, Gisele Fetterman told The Inquirer. She said his father and grandmother also had the heart condition, which can be hereditary.
Fetterman, who once weighed more than 400 pounds, announced in 2018 that he had lost nearly 150 pounds.
However, five years after being diagnosed with the abnormal heart rhythm, he developed a blood clot that traveled to his brain: a stroke. In patients with A-Fib, this can happen because the heart’s left atrium trembles with every beat, disrupting blood flow in a way that increases the risk of a clot.
Gisele Fetterman said her husband was not being treated for A-fib at the time of his stroke. But that‘“That’s not necessarily a cause for concern,” said Pearson, an associate clinical professor at Saint Louis University. Some patients have a few brief episodes of the abnormal heart rhythm with no signs of returning, in which case drugs and other treatments would not be warranted, he said.
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On May 13, Fetterman arrived at Penn Medicine Lancaster General Hospital just minutes after his wife noticed his hanging mouth. Doctors there removed the clot from his brain, the campaign said.
Doctors not involved in Fetterman’s care said his wife’s quick response was vital. If a blood clot in the brain is removed within hours, the patient can make a full neurological recovery, said Thana Theofanis, an endovascular neurosurgeon at Main Line Health-Jefferson Neurosurgery.
“I noticed something was wrong; he didn’t even want to go to the hospital,” Gisele Fetterman told her supporters on pre-election night. “He didn’t want to miss the events we planned, but I insisted. And as always, I was right.”
Now that he’s had a stroke, his doctors may prescribe anticoagulants (blood thinners), among other things, to reduce the future risk of blood clots.
An implantable defibrillator, a device about the size of a tape measure, is placed in the chest of a person at risk of sudden cardiac arrest. Despite the name, that doesn’t mean the heart has stopped, said Joshua M. Cooper, director of cardiac electrophysiology at Temple University Hospital.
Cardiac arrest means the heart has stopped pumping — it’s beating at a dangerously fast, uncoordinated rhythm that almost stops the flow of oxygenated blood. The person soon faints and, if not treated within minutes, is at risk of severe disability or death.
But an implanted defibrillator detects cardiac arrest within seconds and then delivers a shock that “restarts” the heart into a normal rhythm.
The devices are implanted in patients who have recovered from cardiac arrest if they have another. They are also used in people who have never had such an episode but who are at risk of having such an episode for various reasons. These include chronic coronary artery disease and problems with the heart’s electrical system, some of which are inherited.
But one condition that defibrillators don’t address is A-fib, Cooper said.
“It’s not directly related to atrial fibrillation,” he said.
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When stressed Having no direct knowledge of Fetterman’s medical condition, Cooper and Pearson said a defibrillator would never be implanted unless a patient had another condition alongside A-fib.
That could mean that an underlying heart condition led to both A-fib and an increased risk of sudden cardiac arrest. Or it could mean that the A-fib is long-standing, resulting in a weakened heart muscle that would necessitate the use of a defibrillator.
In any case, a defibrillator will not treat A-Fib, a condition that occurs in the left atrium at the top of the heart. Instead, it shocks one of the heart’s lower chambers — the ventricles, which pump blood.
Gisele Fetterman said she saw messages where cardiologists asked if her husband had a second heart condition, but that she didn’t know anything other than A-Fib.
“I’ve seen … speculation about his health from doctors who haven’t treated him,” she said. “But the doctors who treated him, who are doctors, didn’t say that, no.”
Gisele Fetterman said her husband monitors his sodium intake and does heavy lifting banned pending a follow-up appointment at Lancaster General this weekend.
“Then we’ll know more,” she said.
Over a five-year period, 9 out of 10 people with implanted defibrillators never experience cardiac arrest, Cooper said. The devices sit quietly in the chest just in case. For those who go into cardiac arrest, more than 99% of the time, the devices activate successfully and deliver a shock that returns the heart to its normal rhythm, Cooper said.
Those who have passed out after cardiac arrest never feel anything and usually wake up as if nothing happened. For those who remain conscious, the jolt can be uncomfortable. The device not only shocks the heart, but also causes other chest muscles to contract.
“Some people describe it as like a bomb went off in the chest,” he said. “Some people describe it as being hit in the chest by a brick or a bat.”
But given the alternative – severe, long-term disability or death – it’s a welcome event.
“Defibrillators are one of the most effective treatments that we have in modern medicine to keep someone from dying,” Cooper said, “due to the immediate response time of the treatment, which is seconds, and the high efficacy of this treatment.”
Gisele Fetterman has raised questions about her husband’s health on his way to the elections on elementary school day, at his elementary school night party, and in phone interviews since. She often talks about how happy the family is that Fetterman’s stroke occurred so close to a hospital with a large stroke treatment center. She also said Fetterman will use the campaign experience to talk about the need to expand emergency care to more rural parts of Pennsylvania.
“What he wants to fight for is to make sure everyone has access to the same care that they could get anywhere in the country,” she said on preschool night.
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She has repeatedly defended her husband’s ability to campaign and become a US Senator. “I think anyone who says they are unfit for duty is an insult to every other stroke patient,” she said.
The campaign hasn’t said when Fetterman is expected to be back on the campaign trail. His wife said he was eager to resume.
“It’s a good time for a break, though,” Gisele Fetterman said, noting the recount in the GOP Senate primary. “We don’t even know who our opponent is on the Republican side, so this is a much-needed break that he needs and deserves. We wanted to take a week off after Tuesday. It just came sooner than expected, but he’s here.”