FAQs A-Fib Ablations: A Runner’s Heart 

Catheter ablation

“I’m a life-long runner. I recently got intermittent A-Fib. Does ablation (whether RF or Cryo) affect the heart’s blood pumping output potential because of the destruction of cardiac tissue? And if so, how much? One doc said it does.”

As a fellow runner, I understand your concern on how an ablation might affect your ability to resume your athletic activities.

Seek Your Cure: Keep in mind, with Atrial Fibrillation you lose 15% to 30% of your heart’s normal pumping volume along with lower oxygen levels. Your body and brain aren’t getting the blood and nourishment they need. An catheter ablation is an important way to improve or restore your heart’s pumping volume.

Lesions around PV openings

Ablate as Little Tissue as Possible: A common ablation technique for paroxysmal A-Fib (using RF or Cryo), ablates only around the opening of each Pulmonary Vein (PV) and isn’t likely to affect the heart’s output.

On the other hand, more extensive lesion patterns affecting more tissue may affect the heart’s output. For example, during a PV Wide Area Antrum Ablation, instead of just ablating around each of the PV openings, large, oval lesions are made in the left atrium encircling both the upper and lower vein openings.

More extensive lesion pattern

(This is intuitive on my part; we don’t have clinical studies confirming any effect or difference between the two approaches in terms of heart output and atrium function.)

For a runner, the more extensive ablation of the left atrium may affect heart output. Less active patients may not notice the difference, but a runner like you may.

My Best Advice to Runners with Atrial Fibrillation

Seek out the Best EPs: Select the most experienced Electrophysiologists (EPs) you can afford (and travel if you need to). Discuss catheter ablation and your concerns about decreased heart output after ablation. A good EP will make as few lesions during your ablation as possible.

Paroxysmal A-Fib Easiest to Ablate: At the moment you have “paroxysmal A-Fib of recent onset” and it’s usually the easiest to fix. It’s likely you will not need an extensive ablation. (Though one never knows till the actual ablation; Read what Travis Van Slooten wrote about how his “easy case” turned into a complex, extensive ablation.)

Ablate ASAP: Get your ablation as reasonably soon as possible, before your A-Fib has a chance to get worse and requires a more extensive ablation.

Keep A-Fib records in a binder or folder.

Monitor Progress of your A-Fib: A-Fib is a progressive disease. You should track if your heart’s measurements are getting better or worse, and by how much. Ask your doctor for the measurements of heart dimensions and its functions including the diameter and volume of the left atrium, your Ejection Fraction (EF) and any other test results.

Store all your test results and measurements in your A-Fib three-ring binder or file folder.

What Patients’ Need to Know: A progressively enlarging heart and a falling EF percentage (below 35%) means your A-Fib is worsening. To preserve your heart’s best functions, seek an ablation before your A-Fib worsens.

As a runner, even if your heart is somewhat enlarged and your EF has decreased, a successful catheter ablation may not only end your A-Fib and improve your Ejection Fraction but over time may even reduce your enlarged left atrium.

Thanks to Joe O’Flaherty for this question.

Return to FAQ Catheter Ablations
Last updated: Monday, June 18, 2018

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