Arian Foster and Cardiac Ablation: Why His Heart May Not Be In It — Yet

Should Foster consider surgery for his irregular heartbeat? Or has he already?

Foster says he is not considering surgery for his irregular heartbeat. Should he?

Earlier this week, the NFL Network’s Alex Flanagan reported that Arian Foster told her he was likely to undergo an ablation procedure to treat an irregular heartbeat. On Friday, Foster said that Flanagan’s report was just a “casual conversation…turned public” and that not only is he not planning any surgery, he hasn’t discussed it with his doctors.

Even as a known non-conformist of sorts — Foster has tweeted MRI images of his own hamstring injury and generated headlines about a vegan diet — his adamant about-face struck me as odd.

NFL players often undergo more invasive surgical procedures than cardiac ablation. Ablations are reportedly 95% effective (or better) for Foster’s most likely condition. And a cardiac electrophysiologist I spoke with told me that athletes often seek out ablation to put an irregular heartbeat behind them.

Though Foster says otherwise, I think it’s very likely that he has discussed ablation with his doctors. So why might Foster seem to be avoiding ablation?

Before considering that question, let’s briefly look at what an irregular heartbeat likely means for Foster.

The term “irregular heartbeat” is a common, but not specific, description for many different conditions. Some are minor, others can be life-threatening. The details Foster has given about his condition strongly suggest that he has a minor form of supraventricular tachycardia, or SVT.

A person with SVT has episodes when their heart feels like it’s beating more quickly than it should. It’s much like what you feel in a car that revs higher as it accelerates, but then stays at a higher RPM rather than shifting and settling properly into a higher gear.

Essentially, this…

ECG tracing of normal rhythm

ECG tracing of normal rhythm

…becomes this…

ECG tracing of SVT

ECG tracing of SVT

…and the heart rate jumps – and stays – as high as 160-180 beats per minute.

Accelerations like this can occur when the electrical impulses in the heart tissue travel along a different pathway than they should or quickly loop through a pathway they shouldn’t.

That’s where ablation comes in. It’s a procedure that disrupts the bad pathways and prevents future accelerations. But while the medical world considers an ablation a “minimally invasive” procedure, it probably sounds anything but minor to an elite athlete like Foster.

Imagine being told that you’ll lie sedated on a table while a doctor inserts a large catheter into a blood vessel in your groin. The catheter will then be threaded up into your heart where it will be used to destroy the tissue causing your accelerated heart rate.

Though Foster has dealt with his condition since he was a teenager and knows that it could cause him to miss playing time if it happens again, it’s not so hard to see why he may be reluctant to have an ablation.

Most forms of SVT are not life-threatening conditions. The cardiologist I spoke with noted that, while an ablation would likely be recommended for Foster, it would be an elective procedure. Also, since athletes can recover and be cleared to return to play within days of a successful ablation procedure, it isn’t critical for Foster to have the procedure immediately. Foster could change his mind later this offseason and have the ablation without affecting his 2013 readiness.

If Foster decides against an ablation, he could have additional episodes of SVT. The rush of adrenaline and relative dehydration he’ll experience on game days are potential triggers, though it’s impossible to predict when his next episode may be.

Whether or not Foster chooses ablation, I doubt this is the last we’ll hear of his condition.

Categories: Injury Updates

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