Mardy Fish’s Heart Arrhythmia Scare

Mardy Fish used to like it when his heart beat fast. It meant he was working hard. It meant
he was suffering—the kind of suffering that had always been a key ingredient in his
tennis success and had made him the seventh-ranked player in the world as recently
as last summer. In fact, in the past, as the temperature got higher, the air thicker,
and the overall conditions more grueling, Fish, a central Florida native, believed
his chances of winning increased. That’s why he’s always loved playing in Washington
in the dead of summer, as he will again ten days from now at the Citi Open (formerly
the Legg Mason Tennis Classic). “Playing in that kind of heat is not just about being
fit,” says Fish. “It’s about convincing yourself you like it more than the other guy,
and pushing your body farther than you think it will go.”

But this winter, Fish’s body pushed back. And it wasn’t an elbow or a knee, as it
so often is for tennis players. It was his heart. The very organ sportswriters had
cited for years as Fish’s most valuable weapon was betraying him.

It started in February, while Fish, 30, was playing for the United States Davis Cup
team in Switzerland. He awoke in the middle of the night with his heart beating upward
of 170 beats per minute. He banged on the door of his trainer’s hotel room seeking
guidance. His trainer had none. Fish would win a five-set match the following day
as the US defeated Roger Federer’s Swiss squad, but he was too freaked out to celebrate.
He flew home to Los Angeles, and the episodes continued. He became so frightened by
the periodic and unexplained palpitations that he eventually became unwilling to sleep
anywhere except in his own bed. This is a problem for a peripatetic pro tennis player.

Fish was eventually diagnosed with a heart arrhythmia. In March he underwent a procedure
known as a cardiac catheter ablation to correct it. Doctors, guided by x-rays and
MRIs, threaded a wire through a vein in Fish’s groin up to his heart, where they located
and cauterized the source area of the rogue electrical impulse.

If it sounds scary, I assure you it is. I had the same procedure last February.

The arrhythmia that affected me is known as atrial fibrillation (a-fib, for short).
Like Mardy’s, occasionally and without warning my heart would start to flutter. There
was no pain involved. In fact, doctors assured me the condition itself was not life-threatening.
It is, however, extremely disconcerting. During an a-fib episode, blood flow to one’s
lungs, brain, and other vital organs can be reduced by as much as 30 percent. A person
in such a state might get winded from walking up a single flight of stairs, as I did
in the WUSA newsroom one night in 2009—the night I discovered something was wrong.

I took a pass on the sportscast that night and drove with one of our producers to
Georgetown Hospital. A simple EKG revealed the arrhythmia. They explained this was
likely not the first time I had experienced an episode (they sometimes resolve themselves
without medical intervention), and that it would most certainly not be the last. They
tried to restore my normal rhythm that night with a series of drugs, but when none
worked, they opted to perform a cardioversion. That is to say, they shocked me. (I
assume someone said “Clear” before zapping me with the paddles, but I was unconscious
at the time. Cardioversion is not something you want to be awake for.)

For the next two years, I experienced a-fib episodes periodically. There is no medical
explanation for why they occur. There is no genetic mapping that explains why some
people’s hearts generate these occasional rogue electrical currents. One thing doctors
do know is that in people who have the condition, episodes can be triggered by excessive
alcohol, caffeine, and stress. I began to limit the first two of those from my life,
but given my line of work, there wasn’t much I could do about the third.

The same went for Fish.

I found a regimen of drugs that limited the frequency of the a-fib episodes, but,
as predicted by my doctors, I slowly developed a resistance to those drugs, and the
frequency of the episodes increased again. That’s when the catheter ablation became
the only choice.

My surgeons at Washington Hospital Center read me the statistics they are legally
obliged to convey. They are the same ones Mardy Fish undoubtedly heard as he was preparing
for the procedure—that cardiac catheter ablations have a one percent mortality rate.

What?

They assured me these statistics included all outcomes on a national level, including
far less sophisticated hospitals, far less experienced doctors, and far older and
sicker patients. Okay, but still, are you telling me one in a hundred who have this
thing . . . eat it? I inquired if there were any other remedies that were—how shall
we say—less deadly. I considered just continuing to live with the condition. Heck,
I can deal with 70 percent of my normal blood flow. It beats the crap out of zero
percent.

Of course, 70 percent of normal blood flow doesn’t cut it when you’re a professional
athlete, and so assuming Mardy Fish wanted to continue being one, he had no real choice.
Fish had the ablation in March, and with due respect to the good people on Wall Street,
this millionaire was quite happy to be part of the 99 percent.

Fish returned to the tennis court at Wimbledon last month, where he reached the fourth
round. He says he is still nervous about the condition coming back. Cardiac ablations
are only 75 to 80 percent effective on the first go-around. Depending upon how things
proceed, he may yet need another one. The procedure itself is less than 20 years old,
and much of the long-range data is still being compiled.

Here’s what I told Mardy when we compared notes last month: that I am now 18 months
removed from my ablation, and the arrhythmia has never returned. Not once. I take
no drugs and I see no doctors for it (other than an annual visit to a cardiologist,
which, for a guy in his forties, isn’t such a bad idea, regardless of your cardiac
history.) He sounded encouraged by this report, though still understandably apprehensive.

So if you go to the Citi Open in Rock Creek Park the week after next and the top-seeded
Fish happens to lose a match he was expected to win, perhaps you will resist the urge
to question his heart. He’ll be questioning it plenty on his own.