Hi, I have a parent currently going through this and this is the one thing I really am a little bit confused on.
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Once the drugs that cause the paralysis of the heart wears off the heart will just start beating again. The nerves in the heart will send out heart beats on its own whenever they can. So there is no need to start the heart in any way as it starts on its own. The only issue which might arise with this is when the drug wears off in different parts of the heart at different times then the heart might not be synchronized. Part of the heart might beat out of phase with the rest so it is not effective at pumping blood. This is basically a fibrillation. In a healthy adult this situation will resolve itself after a bit of time. The ECMO machine will provide blood flow until the heart is working properly. But if the heart continue to fibrillate then the surgeons might need to use a defibrillator to essentially restart the heart making sure all parts of it is beating in phase. Once the surgeons are able to confirm that the heart is working properly they can start disconnecting the ECMO machine letting the blood flow through the heart as normal.
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