A Candidate's Racing Heart

Som

etimes you just feel a little warm and dizzy. Other times your heart is pounding so fast you're afraid it will leap out of your chest. Either way, the irregular heartbeat caused by atrial fibrillation can seem very alarming. But the condition, which affects 2 million Americans and caused presidential hopeful Bill Bradley to cancel an afternoon of West Coast appearances last week, is not always the intimation of mortality that it seems. A lot depends on just how healthy the heart is in the first place. And in the case of this former Knick forward, who still occasionally enjoys shooting hoops, the ticker appears to be in tip-top shape.

Although Bradley's complete medical record has yet to be released, what we do know is encouraging. His total cholesterol level of 161 mg/dL places him solidly among the heart-smart set. His blood pressure is an enviable 118/68, and his pulse holds steady at 55 beats a minute.

First found to suffer from atrial fibrillation in 1996, Bradley has had seven episodes since then. Before putting him on drugs that kept his heartbeat regular, in 1998, doctors had to apply an electrical current across his chest on three different occasions to get his heartbeat back to normal. But such interventions are routine; they are nothing like the drama-charged ER version. Those are applied only in cases of ventricular fibrillation--a type of irregular heartbeat that is different from the kind Bradley has and more dangerous because it occurs in the two chambers of the heart that do the actual pumping. Bradley's heart settled back into its normal rhythm last week even before he reached the hospital.

Atrial fibrillation occurs when the smaller two chambers of the heart (the atria) contract faster than the two larger ones (the ventricles), causing an erratic but still viable flow of blood. "We don't know all the causes of atrial fibrillation," says Dr. Mel Scheinman, a professor of cardiology at the University of California at San Francisco, who is not involved in Bradley's care. "High blood pressure or coronary-artery disease may predispose patients to develop [the condition]." Other cases, like Bradley's, apparently, occur for no obvious reason.

You might think stress would be a trigger--the former Senator has been putting in 10-hr. days on the campaign trail--but most doctors aren't convinced it's a factor. Peak physical condition, however, doesn't necessarily provide any protection either. Last September Indiana Pacer's coach Larry Bird revealed that he too suffers from atrial fibrillation and developed it while playing for the Boston Celtics.

Atrial fibrillation often resolves on its own. For someone in Bradley's condition, it usually turns out to be more a nuisance than a handicap. And it doesn't seem to interfere much with a high-pressure job. Just ask former President George Bush. During his term in office, he suffered from atrial fibrillation as a result of his thyroid problems.

After you've experienced one bout of atrial fibrillation, however, you're likely to have another. In some cases, that could spell trouble. The uncoordinated beating of the heart allows small amounts of blood to pool in the atria, where the blood can form clots that can travel through the brain, causing a stroke. The risk is greatest for folks 65 and older, who are often given blood thinners like aspirin and the prescription drug warfarin to lessen the risk. But Bradley is 56. And in a Dec. 9 letter to the candidate, his doctor reported that the occasional irregular heartbeat "does not, in any way, interfere with [his] ability to function."