How do paramedics try to restart a heart with a pacemaker?

Paramedics may use an external defibrillator to deliver electric shocks to the heart in cases of cardiac arrest, even if a patient has a pacemaker. They first assess the patient's rhythm to determine if a shock is needed and ensure the pads are placed correctly, avoiding direct contact with the pacemaker. If the pacemaker is malfunctioning or the heart rhythm is not responding to the pacemaker, the defibrillator can help restore a normal heart rhythm. Additionally, paramedics may provide advanced cardiac life support (ACLS) measures to stabilize the patient.