Sen. John Fetterman was hospitalized Thursday after suffering injuries to his face in a fall due to a serious heart condition, ventricular fibrillation. This life-threatening condition is the 56-year-old’s latest health issue in recent years, following a 2022 stroke on the campaign trail that nearly killed him.

Like atrial fibrillation, which caused the blood clot that led to Fetterman’s stroke, ventricular fibrillation is an arrhythmia, an abnormal heartbeat. But v-fib, as it’s sometimes called, is the most severe form of arrhythmia.

It can lead to sudden cardiac death if not treated promptly with a shock to the heart — which is exactly what an implanted defibrillator, the device Fetterman received after his stroke, is supposed to deliver when it detects abnormal heart rhythms.

Fetterman’s staff have not specified whether his defibrillator helped his health outcome, saying only that he felt light-headed before he fell on a morning walk. In the same statement announcing his hospitalization, staffers said he remained under care for routine observation and “has opted to stay so doctors can fine-tune his medication regimen.”

In rare cases, v-fib episodes are brief and go away on their own. But more often, patients need a shock to get their heart beating properly again, and prompt treatment is crucial as death can occur in minutes.

Fetterman’s office did not say whether his defibrillator activated during his episode of v-fib, nor whether he lost consciousness.

Sustaining facial injuries in a fall, as Fetterman did, could indicate a loss of consciousness so swift that a person is not able to brace themselves, Joshua Cooper, director of cardiac electrophysiology at Temple University Hospital in North Philadelphia, told The Inquirer.

Cooper said that ventricular fibrillation is “100% treatable” when prompt care is administered, through an implanted defibrillator or the portable defibrillators available in many public spaces.

Fetterman has dealt with other health issues during his campaign and his time in office — at times facing scrutiny over the pace and extent of his health disclosures.

Atrial fibrillation

Fetterman was diagnosed with atrial fibrillation in 2017 after noticing that his feet were swelling, a common symptom of the condition that causes the upper parts of the heart beat rapidly in a chaotic manner.

Atrial fibrillation, or a-fib, can lead to blood clots in the heart and increase the risk of stroke and heart failure.

Fetterman, who lives in Braddock, Pa., about 8 miles outside of Pittsburgh, visited cardiologist Ramesh Chandra at the University of Pittsburgh Medical Center, and was prescribed medications and dietary changes.

In a letter released by Fetterman’s campaign after his stroke in 2022, Chandra wrote that Fetterman didn’t take his medications and didn’t see any doctor for another five years.

Stroke

Fetterman suffered a stroke on May 13, 2022, four days before winning the Democratic primary for Pennsylvania’s open Senate seat.

His wife, Gisele, noticed that his mouth was drooping — a common stroke sign — and Fetterman was taken to a hospital. Doctors removed a blood clot in his brain before it could cause cognitive damage, his campaign said.

Fetterman said in his memoir released this month, Unfettered, that he knew something was wrong but tried to put off addressing it.

“I knew I was having heart problems. The anxiety and stress of the campaign were wearing me down ... My ankles became swollen with fluid, and little red splotches developed on my skin, something I figured I could handle with a pair of compression socks. I promised myself I would get medical attention right after the primary, go straight to the emergency room. I just had to struggle for a few more days, until the end.”

His campaign said the stroke was caused by atrial fibrillation.

After his stroke, Fetterman underwent surgery where doctors implanted a pacemaker and a defibrillator in his heart. A pacemaker can treat atrial fibrillation, but that’s not a defibrillator’s purpose, leading some experts at the time to question whether Fetterman had another heart condition that the campaign hadn’t disclosed.

Cardiomyopathy

Three weeks after his stroke, Fetterman’s campaign released the letter from Chandra, the cardiologist Fetterman saw in 2017. Chandra said that while a-fib had caused Fetterman’s stroke, doctors had implanted a defibrillator to treat cardiomyopathy, a previously undisclosed heart condition.

Cardiomyopathy is weakness or scarring in the bottom chambers of the heart, which pump blood to the rest of the body. It is a major risk factor for ventricular fibrillation.

Fetterman said in his memoir he was unaware he had that condition until a few weeks after the procedure.

“In early June, I learned that the pacemaker and defibrillator had been inserted to deal with cardiomyopathy, a disease of the heart muscle that can cause the heart to become rigid or enlarged. To be honest, I had thought my heart problems were all due to A-fib: I guess I hadn’t really been listening when my cardiologist, Ramesh Chandra, talked to me about cardiomyopathy several years earlier.”

Auditory processing issues

Fetterman dealt with auditory processing issues after his stroke, a common complication. Although the term auditory is associated with hearing, auditory processing issues relate to how the brain interprets language.

Communication can be affected when the stroke has affected the left hemisphere of the brain, which handles most language functions. Patients may have trouble with spoken communication, or processing language through hearing, reading, or writing.

“It wasn’t that I couldn’t hear. I just couldn’t make sense of what I was hearing,” Fetterman wrote in his memoir. “When I was asked a question directly, I couldn’t understand it. But when the neurologist pulled out a tablet-size size whiteboard and wrote the same question on it, I was able to understand it and respond perfectly.”

Fetterman received intense criticism after an October 2022 Senate debate where he seemed to exhibit some communication issues. He has written that the social media frenzy around his health issues after the debate fueled his worsening depression, for which he eventually sought inpatient treatment.

After his treatment for depression, Fetterman also received hearing aids. While a stroke can trigger hearing loss, experts told The Inquirer that noise exposure is the most typical cause of hearing loss in people in their 50s, around Fetterman’s age.

Depression

About a month after his Senate inauguration, Fetterman checked into Walter Reed National Military Medical Center to be treated for severe clinical depression in February 2023. Days before, he had briefly checked into a hospital for lightheadedness, and doctors had confirmed he was not suffering another stroke.

He would spend 44 days receiving treatment at Walter Reed.

In his memoir, he said that he was having suicidal thoughts, even after his Senate victory, and that attacks about his health had contributed to his depression. He dedicated the book to “anyone with depression, but especially to someone who is considering taking your own life.”

“Depression lies to you. It will try to convince you that taking your life is the solution. Have you ever been physically unable to get out of your bed? Have you ever sized up the ways to do it? I’ve been there. You are not alone.”

Ventricular fibrillation

Fetterman’s office announced on Thursday that the senator was hospitalized after a fall.

He had suffered a “ventricular fibrillation flare-up,” his staff wrote on X, formerly Twitter, and became light-headed and fell, sustaining facial injuries.

His office did not respond to questions seeking more detail about what caused the v-fib and whether he had been diagnosed with v-fib before.

As of 4 p.m. Friday they had not provided updates on his status.

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