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Lt. Governor John Fetterman casts his primary vote from the hospital via absentee ballot

The frontrunner in the Democratic primary for U.S. Senate suffered a stroke on Friday. His campaign said he is having a pacemaker installed to address the issue.

PENNSYLVANIA, USA — Note: The video is from May 16.

Pennsylvania Lt. Governor John Fetterman, who is recovering from a stroke in Penn Medicine Lancaster General Hospital, cast his primary election vote Tuesday using an absentee ballot, his campaign said.

Fetterman's wife, Gisele Barreto Fetterman, cast her vote in-person at a polling place in Braddock, his campaign said.

Fetterman is running for U.S. Senate in the Democratic primary against three-term Rep. Conor Lamb and state Rep. Malcolm Kenyatta. 

He has been in Lancaster General Hospital since the weekend after going to the hospital last Friday.

In a statement issued Tuesday afternoon, Fetterman's campaign said the 52-year-old candidate is undergoing a procedure to implant a pacemaker, which should help address the underlying cause of the stroke he suffered last Friday.

“John Fetterman is about to undergo a standard procedure to implant a pacemaker with a defibrillator," the statement said. "It should be a short procedure that will help protect his heart and address the underlying cause of his stroke, atrial fibrillation (A-fib), by regulating his heart rate and rhythm."

In a video released Sunday, Fetterman said he "just wasn't feeling very well” and went to the hospital at his wife's urging.

In a written statement released Sunday, Fetterman said he suffered a stroke, but insisted he was on his way to a full recovery and said the medical issue would not slow down his campaign for Senate.

“I had a stroke that was caused by a clot from my heart being in an A-fib rhythm for too long,” Fetterman said in the statement. 

He said the doctors were able to remove the clot, “reversing the stroke,” and got his heart under control.

“The good news is I’m feeling much better, and the doctors tell me I didn’t suffer any cognitive damage,” he said in the statement.

Fetterman did not say by what method the doctors removed the clot. His campaign said his exact treatment regimen is still being worked out, but will include rest in the short term and a healthier diet.

Dr. Donald Lloyd-Jones, a cardiologist and chair of the Department of Preventive Medicine at Northwestern University, said clots can be removed with “clot-busting” drugs or, more commonly, by extracting the clot “mechanically” by inserting a catheter through a big artery in the groin.

The longer a clot blocks an artery, the more brain cells can die, so it is critically important to recognize the symptoms of a stroke, said Lloyd-Jones, who is president of the American Heart Association and the American Stroke Association

People who develop A-fib are almost always put on a blood-thinning medication for the rest of their life to help prevent the stroke-causing blood clots that untreated A-fib can create, Dr. Lloyd-Jones said.

Fetterman did not say how much longer he would be in the hospital.

“They’re keeping me here for now for observation, but I should be out of here sometime soon," he said in Sunday's statement. "The doctors have assured me that I’ll be able to get back on the trail, but first I need to take a minute, get some rest, and recover.”

Fetterman is the strong favorite. He has led polls and fundraising from the start, even as the party’s establishment rallied around Lamb. Despite such support, Lamb struggled to reach voters or even pierce Fetterman’s standing with primary voters.

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