Vice President Dick Cheney was back at work Tuesday after doctors administered an electrical shock to his heart and restored it to a normal rhythm after he experienced an irregular heartbeat.
"He feels fine. He is not in any pain," said press secretary Megan Mitchell. Cheney was in his office by 7:15 a.m. and met with President Bush. He planned other meetings during the day and was to meet Tuesday evening with Israeli Prime Minister Ehud Olmert.
Cheney, 66, has a history of heart problems including four heart attacks, quadruple bypass surgery, two artery-clearing angioplasties and an operation to implant a defibrillator six years ago. In July he had surgery to replace the defibrillator which monitors his heartbeat.
He was sedated at George Washington University Hospital on Monday night to allow doctors to administer an electrical impulse to his heart.
The irregular heartbeat was determined to be atrial fibrillation, an abnormal rhythm involving the upper chambers of the heart.
"Atrial fibrillation is extremely common," said Dr. Zayd Eldadah, an electrophysiologist and director of cardiac arrhythmia research at Washington Hospital Center. "The way to get rid of it right away is to do what he did today. This is standard practice, low risk, easy to do."
He said Cheney's underlying heart problems were probably a factor in his atrial fibrillation. Aging is a common factor, too.
"He'll probably have other episodes," said Eldadah, who was not involved in Cheney's care. "Atrial fibrillation in and of itself is not threatening. The problem is that it has long term consequences. It increases the risk of stroke." He said Cheney probably would be put on the most potent blood thinner.
About 2.8 million Americans have atrial fibrillation, the most common type of irregular heartbeat, and cases are increasing as the population ages.
The condition occurs when the heart's top chambers, called the atria, get out of sync with the bottom chambers' pumping action. It is not immediately life-threatening, and the heart sometimes gets back into rhythm on its own. Many times, patients aren't aware of an episode of atrial fibrillation.
But if the irregular heartbeat continues, it eventually can cause a life-threatening complication — the formation of blood clots that can shoot to the brain and cause a stroke.
The main treatment is to try an electrical shock to restore normal heartbeat. If that doesn't work, patients may need to take the blood thinner warfarin to reduce stroke risk.
The type of defibrillator Cheney has is used to prevent sudden death from a very different type of irregular heartbeat that starts in the bottom of the heart. The atrial fibrillation, in contrast, requires a different type of treatment.
In 2005, Cheney had six hours of surgery on his legs to repair a kind of aneurysm, a ballooning weak spot in an artery that can burst if left untreated. In March, doctors discovered that he had a deep venous thrombosis in his left lower leg. After an ultrasound in late April, doctors said the clot was slowly getting smaller.