Larry Bird played basketball with afib (undiagnosed) for years thinking his symptoms were either normal or expected in fierce competition. He was obviously young and paroxysmal. He was diagnosed as a coach. petey

Jonas Gustavsson, goalie for the Toronto Maple Leafs hockey team has had 3 ablations in 16 months, but is still playing.
Large studies in Sweden show that endurance athletes have a much higher incidence of afib than the general population. JR

It doesnt say much about pro basketball team doctors, if they couldn't pick up afib on one of their players.

As the Boston Celtics began to sink into mediocrity in the late 1980s, the press was full of stories about Kevin McHale's feet and ankles and Larry Bird's heel and back and, later, the tragic death of Reggie Lewis from heart failure. It turns out that another significant medical story involving those Celtics never became public: Bird, now coach of the Indiana Pacers, wasand still isplagued by an irregular heartbeat. The condition, called atrial fibrillation, bothered him frequently during off-season workouts in hot weather, and in 1998 it almost caused him to pass out on the sideline during a tense late-season game against the Chicago Bulls. Bird reveals all this in Bird Watching: On Playing and Coaching the Game I Love, a book written with SI senior writer Jackie MacMullan that is scheduled to be released on Sept. 15.

"I always knew there was something funny about my heart," Bird writes. Occasionally during off-season workouts when he was a player, he would feel sudden exhaustion and his heart would start "jumping around." Bird wasn't sure what it was, but he would take a long nap and the feeling would pass. What he calls his "episodes"his resting heart rate would double, to 104 beats per minute, resulting in light-headedness, disorientation and profuse sweatingapparently didn't occur during the regular season, and he never told Celtics doctors about them. That sounds incredible, particularly given the M*A*S*H atmosphere in which the Celts were playing in those days, but that was Bird, always intensely private.

The arrhythmia was discovered after his playing days, while he was working in the Boston front office. The episodes began occurring more frequently, and that compelled Bird to tell team physician Arnie Scheller about his heart. Scheller arranged for tests at New England Baptist Hospital, and Bird had a name for his condition. Atrial fibrillation generally isn't life-threatening, and it's not nearly as serious as ventricular fibrillation, which doctors believe is what Lewis experienced when he died while shooting baskets. Nor is atrial fibrillation as serious as the so-called thick heart condition that contributed to the death of Loyola Marymount's Hank Gathers in '90. Roger Blumenthal, director of preventive cardiology at Johns Hopkins Hospital, describes atrial fibrillation as "generally benign" but notes that it may have long-term consequences. "People with atrial fibrillation are more likely to experience enlargement of the heart, which can lead to blood clots and stroke," he says. About two million Americans have the condition, and more than a quarter of those over 65 with atrial fibrillation will suffer strokes.

After his condition was diagnosed, Bird was told to exercise, eat and drink alcohol only in moderation and was put on medication. Still, his condition worsened in the spring of 1997, about the time he started talking to the Pacers about becoming their coach. "I got a little scared, because it didn't seem like it was going away," writes Bird. At one point Indiana team cardiologist King Yee, who had gotten involved after Bird had tests at Methodist Hospital in Indianapolis, used defibrillator paddles to jolt Bird's heart back to its normal rhythm.

Yee warned Bird to take particular caution in hot weather and at high altitudes. Sure enough, Bird suffered an attack during a road trip to Denver early in the 1997-98 season. Bird admitted to Yee that he had forgotten to take his medication, which included blood thinners, and thereafter Pacers trainer David Craig was appointed to remind Bird about his medicine. Bird writes that he was fine until the Bulls came to town on March 17, 1998. At one point during the game, Bird's heart began fluttering and he started sweating profusely. "I was standing on the sideline and hoping for a television timeout, because I felt like I was gonna pass out," he writes. "Finally, the ref whistled time. Whenever we have a timeout, they always put a chair on the court for me so I can sit down and talk to the guys. This time I fell into that chair, because I was going out." The feeling passed by the end of the game, which Indiana lost 90-84.

The episode against the Bulls led to sterner lectures from Yee about taking the condition seriously. "I guess Dr. Yee was trying to scare me," writes Bird. "I'm not going to be stupid about this heart condition, but I'm not going to live my whole life in fear of this thing either. If it goes, it goes." That sounds like Bird. But let's hope that he has learned a few lessons and that Yee won't have to repeat something he told Bird after he forgot to take his medication in Denver: "You know, Larry, you're not the most compliant guy in the world."


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Thanks for the article. I think I had a similar experience when I was competing in sports. As part of my cross training, I used to do a lot of swimming. In my training diaries (in high school!) I had comments about skipping heart beats... so for me, this has been going on for a very long time.

It's very disheartening to hear that no pro athletes have been able to continue their sports after diagnosis. I think it's also pretty sad that there doesn't seem to be any real push to find a cure for afib.

In my opinion, and my opinion only, we're heading down a dead end road with ablation. I'm convinced it will eventually be abandoned because it doesn't seem to offer a long term cure... and there are some serious risks with it. We also don't know what will happen to the heart 20 years down the road after ablation.

(Disclaimer).. each of us must make our own decisions, and I'm not, in any way, criticizing those who have decided to try ablation.

What I don't understand is why afib is minimized in the health community. There aren't the "pink ribbons" and "walk a thons" to raise awareness and money for research. There really isn't any sort of big movement.

In my opinion, and my opinion only, we're heading down a dead end road with ablation. I'm convinced it will eventually be abandoned because it doesn't seem to offer a long term cure... and there are some serious risks with it. We also don't know what will happen to the heart 20 years down the road after ablation.

(Disclaimer).. each of us must make our own decisions, and I'm not, in any way, criticizing those who have decided to try ablation.

Islandluver, Very well said and that is exactly how I feel about it to a tee. Rick

It seems afib is caused by an array of reasons. Ablation seems to be a simple mechanical solution to a biochemical electrical problem... hit the wires with a hammer. petey

I haven't done any extensive research on the various ablaltion options. Like the freezing one (cryo) and they're/it's success vs. the burning one that is usually used. At this point there must be some thought on which is less hurtful to the heart and takes the heart less longer to heal? The Watchman thing is interesting as well although it has nothing to do with the rest of the heart!

islandLuvr makes some interesting/controversial points about the future of ablations. Quite frankly, where will they go if they abandon this process? It seems like it's taken many years to get where they've gone with it and if attacking the nerves isn't the answer, (which it might not be) then what is going to be the new road they go down/pursue?? What is there as an option for those that have had zero luck/success with any medication regimes and are at the end of their ropes?? Heart transplants??

I agree about the lack of public awareness and the attention being brought to this condition.

This is what prompted me to post a few of the posts I just put up,.... 'cos no-one understands anything about it - even some medical professionals have seriously conflicting views about it. Some of the remarks i've heard first hand coming from Nurses makes me cringe just to even think about them - ridiculous!

I think you are right concerning lack of consensus in the medical community regarding best and safest procedures. Also I agree concerning the uncertainty of the future of afib treatment. The 2 main reasons to get an ablation (originally) was to once and for all be rid of afib and eliminate stroke risk (while minimizing risk of the procedure itself). Neither one has materialized. People have to still take anticoagulants (some are told they don't need them, but I wouldn't take the chance)because of asymptomatic bouts of afib. Ironic. The thing that is the biggest reason for getting ablation now after the first two reasons didn't pan out is freedom from symptoms... but not freedom from strokes and recurrence.

That brings us back to the age old question... if a person has asymptomatic afib in the woods and there isn't an EP with a 24/7 EKG machine to measure it... do they still have afib?

Unfortunately in this case, we know the answer is "yes", or at least we can't be sure the answer is "no".

petey

Being in the medical field, I hate to say this but, as long as there is a demand and money to be made, ablations will continue. There will have to be some new and better technology developed, before ablations become obsolete. It may not offer a permanent cure, but it offers hope.

I'm just glad the errant electrical signals aren't coming from the brain... that would be a tricky ablation. We'd be like McMurphy in "One Flew Over The Cuckoo's Nest". petey

I don't know as there is money to be made on ablations here in Canada due to the way the health care system works, but after one unsuccessful ablation, and finding I cannot tolerate rhythym control drugs it seems I am back to square one--suffering through at least 4 episodes a month, and no running, no triathlons, no alcohol, no coffee, no chocolate, NO FUN! As to a heart transplant, that wouldn't help as it is an electrical problem.

I was joking regarding the heart transplant suggestion. But that said, yes of course it would work. We're talking about the entire heart. How much/many advances/success has there been with pacemakers where AF is concerned? Does anybody know? ;)

So glad you asked Surfrat:

Question: How do pacemakers help prevent atrial fibrillation?

Answer :There was a lot of hope a number of years ago that pacemakers would prove to be an effective treatment for atrial fibrillation. But in fact they're very ineffective, and they do not treat atrial fibrillation.

There's only one situation where pacemakers play an important role in patients with atrial fibrillation, and that is in patients who have both atrial fibrillation and they have slow heart rhythms. That's a condition that's referred to as tachy-brady syndrome.


ABC News Photo IllustrationSo there are some patients that will go into atrial fibrillation for a period of time. The atrial fibrillation will stop and then their underlying heart rate is extremely slow. And in those patients, it makes sense to put in a pacemaker because for two reasons. One, that will normalize the heart rhythm. And two, in the setting of this A fib and a slow heart rhythm, putting in a pacemaker may reduce the amount of atrial fibrillation you're having. But more importantly, the presence of a pacemaker will allow your doctor to put you on anti-arrhythmic medications safely.

If you have a tendency for a very slow heart rhythm, if you were placed on and anti-arrhythmic medication, your heart rate may get so slow you could get dizzy or pass out. So pacemakers are really used to allow your doctor to put you on an anti-arrhytmic medication.

But I think it's important to realize that pacemakers are not an effective treatment for atrial fibrillation, but many patients with atrial fibrillation have a pacemaker to allow your doctor to put you on medications.

petey

There are a couple of younger basketball players who still play and some pro rugby players. Jerry West played with his. I think Bill Bradley had his first big event after he was running for President.

I had the cyro-ablation a few months ago and am doing well. Now on to fix my hip!

I would recommend the poem "Fable of the Bees" by Bernard Mandeville written in 1705. In it he describes how our society works including a reference to doctors which reminds me of some of the comments on this forum:

Physicians valued Fame and Wealth
Above the drooping Patient's Health,
Or their own Skill: The greatest Part
Study'd, instead of Rules of Art,
Grave pensive Looks, and dull Behaviour; [75]
To gain th'Apothecary's Favour,
The Praise of Mid wives, Priests and all,
That served at Birth, or Funeral;
To bear with th'ever-talking Tribe,
And hear my Lady's Aunt prescribe; [80]
With formal Smile, and kind How d'ye,
To fawn on all the Family;
And, which of all the greatest Curse is,
T'endure th'Impertinence of Nurses.

The point of his poem is that it is precisely greed and self-interest that makes for a highly functioning and productive beehive (and society).