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Something going wrong with your defibrillator after one year is very rare, you should be having it checked once every three months or sooner by now and it should not require a hospital visit I would call the doctor's nurse and ask them when they the defibrillator technician will be in checking them and you should not need a doctor's appointment. Also in less there is something wrong with the defibulator or it needs to be readjusted they will get the doctor. The technician sees them and sees people like us every day all day so they will know by looking at their computer screen whether you're having a problem that requires the doctor or if everything is checking out just fine but again rather than calling and leaving a message for the doctor, he is very busy, it's difficult for him to call back and he sees many people, I've found it's much easier to leave a message for the doctor's nurse who handles most everything for the doctor and sees a lot of people with problems just like ours and then the nurse also sees what the doctors suggest they do. You may be feeling Atrial Fibrillation, a-fib , that is what I have and it comes and goes at first, I had it for only a few minutes at a time but in seven years it has gotten worse or I should say just last all the time 24 hours a day, now if that's it, you will get used to it will take some time I found laying on my left side I feel it more in bed when everything else is still than when I lay on my right side. They say if you bear down like you're going to the bathroom that may get you out of it, but that doesn't work for me anymore. Three things you should watch out for is; if you have shortness of breath you're not getting enough blood flow; if your ankles start to swell your heart is not pumping well enough to remove the fluid; and you should find out what your ejection ratio is, that is how much blood the hart squeezes out on each pump I think 60% is normal and 25% is you're getting close to what doctors call end of life. So it's important that you know what this number is and keep track of it, if you were holding steady or going downward in a bad direction. I am about 40 to 45%. The test to find that ejection ratio is the same test they used to look at babies before they are born.

About 2.2 million Americans have atrial fibrillation, putting them at risk of
clots and strokes. About 15 percent of strokes occur in people with AF.

BELIEVE IT OR NOT, ATRIAL FIBRILLATION IS THE MOST COMMON form of arrhythmia, affecting more than 2 million people annually. Until just a few years ago health care providers thought AF to be a "nuisance" arrhythmia with few consequences. However, recent medical research has uncovered some devastating complications including stroke, congestive heart failure and cardiomyopathy that are directly related to AF.

Research has yet to uncover the definitive cause of AF. A number of other health conditions including thyroid disorders, valve disease, hypertension, sick sinus syndrome, pericarditis, lung disease, and congenital heart defects are also associated with AF. This type of arrhythmia can occur at any age, but its prevalence tends to increase with age and affects men slightly more often than women.

How things are supposed to work

To better understand the mechanism and characteristics of AF, it is best to begin by describing the normal mechanical and electrical activity of the heart. The heart is a muscle and functions primarily as a double-sided pump. The left side of the heart pumps blood rich in oxygen to supply all parts of the body, while the right side of the heart pumps blood back to the lungs to pick up more oxygen.

There are four chambers, two upper chambers called the left and the right atria and two lower chambers known as the right and left ventricles. Separating these upper and lower chambers there are valves that passively open and close to direct the flow of blood. The left ventricle performs the most work and is the strongest of the chambers because it ejects blood into the aorta (the main pipeline that supplies oxygenated blood to the entire body).
In order for the heart to pump, it must first receive some sort of electrical stimulation that will cause the muscle to contract. During a normal heart beat, an electrical impulse originates in the right atrium in the sinoatrial node (SA node) and travels simultaneously to the left atrium and down the interatrial septum to the atrioventricular node (AV node). The impulse slows briefly at the AV node and then continues to travel down a common pathway splitting off into the left and right bundle branches located in both ventricles. This cycle of electrical stimulation is known as normal sinus rhythm (NSR), which describes a form of orchestrated synchrony between the atria and the ventricles of the heart, producing the familiar (lub-dub) heart sounds.
What exactly is
atrial fibrillation ?

In the broadest sense, AF represents the loss of synchrony between the atria and the ventricles. Typically, AF is characterized as a storm of electrical energy that travels in spinning wavelets across both atria, causing these upper chambers to quiver or to fibrillate at 300 to 600 times per minute.

For many years, AF was believed to be a completely chaotic event with unorganized electrical impulses bouncing around the atria randomly. However, research and computerized mapping techniques have provided greater insight into the mechanism of AF. Typically, there are at least six different locations in the left and right atria where relatively large circular waves can occur, creating a pattern of continuous electrical activity that is characteristic of complex AF. This important discovery paved the way for the development of the Maze procedure, a surgical intervention that extinguishes atrial fibrillation.

Atrial fibrillation can also occur as a secondary event. For example, a trigger mechanism such as a premature atrial contraction (PAC) has been associated with the initiation of AF in some patients. A great deal of interest in this type of premature beat has resulted from a recent study by Haissaguerre, an electrophysiologist from France. His research focused on a small group of patients who experienced frequent PAC's during a Halter monitor study (24 hour EKG recording of one's heart rhythm). In this group of patients, Haissaguerre performed a comprehensive electrophysiologic (EP) study of the left atrium and discovered that in each of these cases, the pulmonary veins appeared to be the primary foci of premature beats. He reasoned that if he could locate the trigger points within and extinguish the source of PAC's, the AF would cease. In this study, Haissaguerre reported that he was able to locate these trigger points and successfully ablate the sites. When this report was published, electrophysiologists around the world became very interested in this form of AF treatment, because now something could be done to combat atrial fibrillation in patients who were unresponsive to medical therapy without having to resort to surgery. So it appears that there may be more than one mechanism responsible for AF.

Other arrhythmias such as atrial tachycardia and atrial flutter may also be initiated from a single region of either atrium and subsequently degenerate into AF.

A palpitation is an awareness of the beating of the heart, whether it is too slow, too fast, irregular, or at its normal frequency. Palpitations may be brought on by overexertion, adrenaline, alcohol, disease (such as hyperthyroidism) or drugs, or as a symptom of panic disorder. More colloquially, it can also refer to a shaking motion. It can also happen in mitral stenosis.

Nearly everyone experiences an occasional awareness of their heart beating, but when it occurs frequently, it can indicate a problem. Palpitations may be associated with heart problems, but also with anemias and thyroid malfunction.

Attacks can last for a few seconds or hours, and may occur very infrequently, or more than daily. Palpitations alongside other symptoms, including sweating, faintness, chest pain or dizziness, indicate irregular or poor heart function and should be looked into.

Palpitations may also be associated with anxiety and panic attacks, in which case psychological assessment is recommended.