He had his fifth heart attack — a “mild” one — back in February and then spent three days in the hospital last month to treat fluid build-up associated with coronary artery disease. Now this.

As many of you know, I have dealt with coronary artery disease for decades, suffering my first heart attack in 1978 at age 37. Over the years, excellent care from my doctors and advances in medicine and technology have allowed me to live a full and active life, for which I am very grateful.

A few weeks ago, it became clear that I was entering a new phase of the disease when I began to experience increasing congestive heart failure. After a series of recent tests and discussions with my doctors, I decided to take advantage of one of the new technologies available and have a Left Ventricular Assist Device (LVAD) implanted. The LVAD is a small implantable pump that improves heart function and will enable me to resume an active life.

Last week I underwent surgery at Inova Fairfax Heart and Vascular Institute and had an LVAD implanted. The operation went very well and I am now recuperating.

I am grateful for the wonderful care that I have received over the years at George Washington University Hospital, and that I am currently receiving at Inova Fairfax Heart and Vascular Institute.

I also want to thank all of you who have included my family and me in your thoughts and prayers.

He’s been keeping a conspicuously lower profile lately than he did last year, when it felt like he was giving interviews every other week laying out The One for his terrorism policies. Whether that’s due purely to his health or partly to political concerns — not wanting to overshadow Liz, not wanting his poor favorable rating (which has been improving but remains negative) to hurt the GOP — only he knows, but congestive heart failure is bound to slow down even Darth Vader. Best wishes to him.