Arian Foster likely to undergo heart procedure

[NCTexan]

http://www.nfl.com/news/story/0ap100...eart-procedure

On tablet, so no preview, sorry about that.

[Playoffs]

Arian Foster considering undergoing heart procedure

01/31/13
Texans running back Arian Foster tells me he'll likely undergo a heart procedure in about a month. The Pro-bowler is considering a heart ablation to fix the problem that forced him to leave the Texans week 16 match-up against the Vikings because of an irregular heartbeat. Foster has been aware of the issue with his heart since he was around 12 years old and says over the years he's had around 8 incidents where his heart has raced irregularly. This last one though, was the first time it had ever happened during a game.

Arian says the biggest side effect for him is shortness of breath. After experiencing that problem this season in a game he started discussing his options for fixing it with trainers and doctors. That's when he says he learned Hakeem Olajuon suffered the same condition.  The basketball player's doctors were able to determine that Olajuon's trigger was drinking cold water. *Arian has been searching for his trigger and tells me he's now thinking it might be releated to stress. It certainly hasn't hurt his performance on the field as over the past 3 years he's been one of, if not, the best running back in the NFL.

This is right up Dr. CND's alley, so we'll get good info on the procedure.

[Vance87]

I wonder if he has SVT, and is getting an ablation.

I have SVT, heart surgery is not necessary but is common for athletes to get rid of the rapid heart beat.

[Fili]

Talking about this on 610 right now.

[CloakNNNdagger]

Cardiac ablation is a very common procedure performed for many types of arrhythmia such as atrial fibrillation, SVT (supraventricular tachycardia), WPW (Wolf-Parkinson-White), etc. These conditions occur due to an abnormal trigger tissue in the heart trying to take over the normal anatomical heart tissue trigger (the sinoatrial node [SA node]) that lies in the atrium of the heart. When these conditions are present, the pumping of the heart is not in sych, and therefore does not distribute the blood and oxygen to the brain and all parts of the body efficiently. Symptoms produced can include dizziness, weakness, fatigue, shortness of breath, and in general a lack of feeling of well being. Many of these entities may be controlled with medication. Most of the time, ablation is performed if medications for these entities do not control effectively, or produce side effects that are intolerable. Most of these conditions will be successfully resolved effectively after ablation.

It seems that reporting on Arian is stuck on "shortness of breath" as possibly being a life-threatening condition, where in truth, with any of these entities untreated, there can be an element of intermittent shortness of breath that may be bothersome but very seldom life-threatening. If Arian was suffering from an arrhythmia that was life-threatening such as ventricular tachycardia (VT)........or arrhythmia not essentially controlled by meds.....he would have been restricted from playing football until well controlled. Since it seems that he was on medications that he tended to skip on game day, it makes me think that he was on a beta-blocker for atrial fibrillation with fast response heart rate. If anyone has ever taken a beta-blocker (such as Inderal), you know that it slows down the heart rate, can make you extremely sluggish, dizzy and fatigued, and can in itself give you shortness of breath as it is a broncho constrictor (constrictor of airway). These side effects would be why he would want to stop taking it on the day of a game. When doing so, the interruption can lead to a temporary breakthrough of the arrhythmia.........which is what I believe Arian experienced in practices and in that one game..........times where stressors upon the heart are maximal.......and where effects of either the arrhythmia (without the beta blocker to fully control) or the effects of the beta blocker are most likely to be felt.

***************

Normal synchronous progression of electrical distribution from the SA node (on the left)

Chaotic progression of electrical distribution from the SA node and AV node (abnormal tissue source) leading to atrial fibrillation and non synchronous inefficient pumping of the heart (on the right)



****************
Catheter ablation (burn destruction) of the AV node

[thunderkyss]

Originally Posted by CloakNNNdagger

Cardiac ablation is a very common procedure performed for many types of arrhythmia such as atrial fibrillation, SVT (supraventricular tachycardia), WPW (Wolf-Parkinson-White), etc.

Thanks for the info.

What kind of surgery/procedure are we talking about? Is this something that will sideline him for a couple of weeks recovering, or a couple of months?

[CloakNNNdagger]

Originally Posted by Fiddler

Thanks for the info.

What kind of surgery/procedure are we talking about? Is this something that will sideline him for a couple of weeks recovering, or a couple of months?

Recovery time depends on the type of ablation and anesthesia used. Patients who undergo atrial flutter or other right sided atrial ablations such as SVT usually go home the same day. These are done under IV conscious sedation anesthesia. Atrial fibrillation ablation patients have an overnight stay. This procedure is done under general anesthesia. Patients have to lie flat for a few hours before the sheaths (big IVs) are pulled from the groin. They can walk around 6 hours after the procedure. The recovery usually depends on how patients recover from general anesthesia. It is advised not to undergo anything more than mild physical exertion for one week after the procedure. Many patients feel shortness of breath and cough for a week or two after the procedure. After that, patients can ease back to strenuous activity quite quickly.

To give you an idea of success of ablation, it depends highly on the specific arrhythmia being treated. Right sided atrial flutter- 98% with first attempt at ablation. SVTs- typically around the normal conduction system of the heart- 90-95%. Paroxysmal Atrial Fibrillation- about 85% at 3 months when the scars are fully formed. About 15% of patients need a second touch up ablation after this period. After 2 ablations the success rate is about 95%
Persistent atrial fibrillation- The success rates for catheter ablation for persistent atrial fibrillation depend mostly on the length of time spent in atrial fibrillation and control of triggers such as hypertension and sleep apnea. Patients who have had atrial fibrillation continuously for less than a year have the best outcomes. After five years the success rate drops off significantly. Overall the success rate is about 70% with the first ablation procedure utilizing the Bordeaux step wise technique. After three months, about 30% of patients need a second procedure. Typically the second ablation procedure is directed at a more organized rhythm that is either coming from a specific point in the upper chambers (atrial tachycardia) or a circuit that goes round and round (atrial flutter). The second procedure is usually not as extensive as the first. After two ablations the overall success rate is about 90%.

[HoustonFrog]

As I've explained on here before I had ablation for my a-fib and didn't find it "minor" at all. This was a guy who was a top doc in this field in Houston. At the time they were switching from doing it more from hand to a robot arm like device that is allegedly making it more precise. They pierced my heart and almost killed me. Had to rush me to get opened up and stitch my heart before I bled out. From all I was told it was touch and go. Not only that but the ablation didn't work. Many people have to go back for follow ups. I was a great candidate..young, rarely went out of rhythm, only taking rhythm meds when it went out of rhythm...pill in pocket. They tried to blame some of it on me moving..they didn't put me all the way under. Another doc I went to after this said he would never do that. So I'm sure he is getting as many opinions as possible. I'd never call it minor though.

[CloakNNNdagger]

Originally Posted by HoustonFrog

As I've explained on here before I had ablation for my a-fib and didn't find it "minor" at all. This was a guy who was a top doc in this field in Houston. At the time they were switching from doing it more from hand to a robot arm like device that is allegedly making it more precise. They pierced my heart and almost killed me. Had to rush me to get opened up and stitch my heart before I bled out. From all I was told it was touch and go. Not only that but the ablation didn't work. Many people have to go back for follow ups. I was a great candidate..young, rarely went out of rhythm, only taking rhythm meds when it went out of rhythm...pill in pocket. They tried to blame some of it on me moving..they didn't put me all the way under. Another doc I went to after this said he would never do that. So I'm sure he is getting as many opinions as possible. I'd never call it minor though.

Frog,

We've talked about your perforation in the past. It is a scarey and terrible thing to go through and can definitely be life-threatening. That is why it is prudent to only do it in a hospital setting, where in the unlikely event that the chest must be quickly opened, it can be done so to save the patient's life. It is a real potential complication seen with ablation. I don't know if it was an "excuse" or not. However, any patient movement during the procedure and the catheter tip can easily be displaced to burn the wrong area or to burn too deeply (through the heart wall-perforation). That is why general anesthesia is specifically recommended for atrial fibrillation, where the heart is already itself moving in irregular and unpredictable fashion, without patient movement. The complication rate for ablation seems to be consistently somewhat higher for atrial fibrillation than for other arrhythmias.
I'd be curious concerning how many robotic ablation procedures your cardiologist or surgeon had performed before yours, as there is a steep "learning curve" to the use of the robot. Some surgeons have a great reputation with traditional tactile surgery, but have a difficult time transitioning that expertise to the robot, especially near the beginning.

Ablation, no doubt, carries significant risks although in small number of cases. However, as you have found out, you might not care that the risk is 1 in 1000....if you are that one. That is why the procedure must be justified by significant supportive indications.

[HoustonFrog]

Originally Posted by CloakNNNdagger

Frog,

We've talked about your perforation in the past. It is a scarey and terrible thing to go through and can definitely be life-threatening. That is why it is prudent to only do it in a hospital setting, where in the unlikely event that the chest must be quickly opened, it can be done so to save the patient's life. It is a real potential complication seen with ablation. I don't know if it was an "excuse" or not. However, any patient movement during the procedure and the catheter tip can easily be displaced to burn the wrong area or to burn too deeply (through the heart wall-perforation). That is why general anesthesia is specifically recommended for atrial fibrillation, where the heart is already itself moving in irregular and unpredictable fashion, without patient movement. The complication rate for ablation seems to be consistently somewhat higher for atrial fibrillation than for other arrhythmias.
I'd be curious concerning how many robotic ablation procedures your cardiologist or surgeon had performed before yours, as there is a steep "learning curve" to the use of the robot. Some surgeons have a great reputation with traditional tactile surgery, but have a difficult time transitioning that expertise to the robot, especially near the beginning.

Ablation, no doubt, carries significant risks although in small number of cases. However, as you have found out, you might not care that the risk is 1 in 1000....if you are that one. That is why the procedure must be justified by significant supportive indications.

Right. I actually went in expecting it by hand and not the robot. From what I learned later I believe he was still a little raw with the robot arm. The specialist I saw in a follow up said the curve is steep and explained that he had done many to get good but had some issues...not perforations. He also said he would have put me completely under and that he used a temperature gauge in the throat because there is a minor chance that the burning could affect the esophagus that's letting bacteria in. It still bugs me to this day because the afib is more frequent now...every few months vs yearly...and the scar tissue, etc affected my stomach some. Plus they couldn't get a wire out of my skin and it pokes around some. Lucky surgeon who saved me was top notch. I know all if this us extremely rare but I kind if laugh about "minor" in reports. Thanks CnD. Hope all is well.

[Say Watt]

Originally Posted by CloakNNNdagger

Frog,

We've talked about your perforation in the past. It is a scarey and terrible thing to go through and can definitely be life-threatening. That is why it is prudent to only do it in a hospital setting, where in the unlikely event that the chest must be quickly opened, it can be done so to save the patient's life. It is a real potential complication seen with ablation. I don't know if it was an "excuse" or not. However, any patient movement during the procedure and the catheter tip can easily be displaced to burn the wrong area or to burn too deeply (through the heart wall-perforation). That is why general anesthesia is specifically recommended for atrial fibrillation, where the heart is already itself moving in irregular and unpredictable fashion, without patient movement. The complication rate for ablation seems to be consistently somewhat higher for atrial fibrillation than for other arrhythmias.
I'd be curious concerning how many robotic ablation procedures your cardiologist or surgeon had performed before yours, as there is a steep "learning curve" to the use of the robot. Some surgeons have a great reputation with traditional tactile surgery, but have a difficult time transitioning that expertise to the robot, especially near the beginning.

Ablation, no doubt, carries significant risks although in small number of cases. However, as you have found out, you might not care that the risk is 1 in 1000....if you are that one. That is why the procedure must be justified by significant supportive indications.

What is your main specialty, Doc? Just curious because your knowledge on all of these subjects just blows my mind. If you specialize in a field that I see a doctor for, I'd love to come see you.

I too had an ablation. I agree with HoustonFrog that it is anything but "minor" for those experiencing it. I was in surgery for close to 7 hours and when I woke up, I thought I was dying. Worst experience of my life. It took me screaming for the idiots in the hospital to finally realize how much pain I was in and come shoot me up with morphine.

I really feel for Arian. Sucks to be young and otherwise healthy but have to deal with a heart that just randomly ****s up for no reason.

[htowntexans1985]

John McClain
@ McClain_on_NFL

By the way, Arian Foster won't be
undergoing a heart procedure. He's
had an irregular heartbeat snce he
was 8 and has missed 1/2 of a game.

[Vance87]

Yeah CND that's basically what I said but in 500 or so less words...

[htowntexans1985]

Its Official. We can all breathe now

Jason La Canfora
@ JasonLaCanfora

Texans RB Arian Foster released a
statement today rebuking a report
that he will undergo a procedure to
correct an irregular heartbeat issue

[thunderkyss]

Originally Posted by htowntexans1985

John McClain
@ McClain_on_NFL

By the way, Arian Foster won't be
undergoing a heart procedure. He's
had an irregular heartbeat snce he
was 8 and has missed 1/2 of a game.

The General nailed it.

[CloakNNNdagger]

Originally Posted by Say Watt

What is your main specialty, Doc? Just curious because your knowledge on all of these subjects just blows my mind. If you specialize in a field that I see a doctor for, I'd love to come see you.

I too had an ablation. I agree with HoustonFrog that it is anything but "minor" for those experiencing it. I was in surgery for close to 7 hours and when I woke up, I thought I was dying. Worst experience of my life. It took me screaming for the idiots in the hospital to finally realize how much pain I was in and come shoot me up with morphine.

I really feel for Arian. Sucks to be young and otherwise healthy but have to deal with a heart that just randomly ****s up for no reason.

Now mainly as a Plastic Aesthetic and Reconstructive surgeon with a heavy background as a trauma surgeon and cardiovascular surgery. I have always tried to stay up with as much of the medical literature in the various specialties as I can.

It is evident to me that with your ablation lasting 7 hours must have been complicated........typically they can last anywhere from 3 to 6 hours (depending on the situation). PM me if you have any specific questions about your situation. The severe pain is usually due to the significant inflammatory changes created by the "burning" of the lining tissue of the heart.......the more extensive the ablation area(s), the more likely more residual inflammation and greater pain. Most routine ablations, though, result in a short period of mild to moderate chest discomfort which is mostly felt with taking deep breaths.....and usually lasting less than 72 hours, during which time Advil or Motrin usually suffices.

[CloakNNNdagger]

Originally Posted by htowntexans1985

Its Official. We can all breathe now

Jason La Canfora
@ JasonLaCanfora

Texans RB Arian Foster released a
statement today rebuking a report
that he will undergo a procedure to
correct an irregular heartbeat issue

Originally Posted by htowntexans1985

John McClain
@ McClain_on_NFL

By the way, Arian Foster won't be
undergoing a heart procedure. He's
had an irregular heartbeat snce he
was 8 and has missed 1/2 of a game.

Guess we scared him!

[CloakNNNdagger]

I doubt that this whole thing came out of the clear blue, but.........

From USA TODAY

Houston Texans running back Arian Foster was forced out of a Week 16 loss to the Minnesota Vikings because of an irregular heartbeat. As a result, the NFL Network is reporting that Foster is considering a medical procedure to fix what has been a recurring issue for him since he was a kid.

Alex Flanagan of NFL Network reported Thursday that Foster said he is likely to undergo a cardiac ablation in about a month.

In a statement released through the team Friday, Foster denied that surgery was planned and that he has no conversations with his doctors about surgery.

"Thank you all for the concern. As of now, I have no complications with my blood pumper. There was a casual conversation with a reporter about my particular condition that turned public. But I have not, nor do I plan to anytime in the near future, have conversations with my doctors about any surgery. I am feeling well and am as exuberant as ever. Love and light to all those concerned!"

[Yankee_In_TX]

I remember when he tweeted an MRI and said 'hey, I'm fine!'

Just sying....

[CloakNNNdagger]

Originally Posted by Yankee_In_TX

I remember when he tweeted an MRI and said 'hey, I'm fine!'

Just sying....

Was thinking the exact same thing. Not sure that Arian has a normal filter.