Frank Bourn

On a sultry August morning, Frank Bourn walked out of the Holiday Inn in downtown Rochester and joined the hotel's annual Half Marathon/5K runs. It was Bourn's first half marathon and he finished in just over two hours despite the humid, heavy air. Perhaps commendable, but not remarkable ... except that Frank had recently suffered from severe fatigue, undergone cardiac ablation and talked with his Mayo Clinic cardiologist before participating.

A few years prior, Frank was training for long-distance runs and logging hundreds of miles on his bicycle each year. "I started getting winded and fatigued more easily, but I attributed it to being 57 years old," recalls Bourn. "I thought my stamina was waning and it was a natural part of the aging process." Bourn kept on running, believing that regular conditioning would improve his endurance. But the opposite occurred. The more he ran and cycled, the more winded he got.

Physical activity had always been integral in Bourn's life. He swam competitively in college, and his training for air force combat included a year of rigorous workout routines. Bourn kept up his conditioning throughout his working years at Cargill in Minneapolis, where he's an accountant in commodity trading.

When good days turn bad

"My idea of a good day was to bike round-trip from home to work ... or get a ride in to work and jog home," says Bourn. "For quite a while that was 11 miles one way. So when I started slowing down, my wife, Andrea, suggested I have a physical," recalls Bourn. "And she didn't just recommend it, she scheduled it."

After his physical examination, Bourn's doctor ordered an EKG. "The technician first tried different wires or leads because she thought they were bad. Then, she wheeled in a different EKG machine because she thought the first one wasn't working. Finally, she realized it wasn't faulty equipment, but a very bad heart rhythm," recalls Bourn.

In medical terms, Bourn suffered from atrial fibrillation — a type of irregular heartbeat. In atrial fibrillation, the top chambers quiver, resulting in less-efficient blood circulation, and an irregular pulse. While some people are immediately aware of atrial fibrillation due to palpitations (fluttering) in the chest, others feel more subtle symptoms such as fatigue or exercise intolerance. Some people have no symptoms at all.

"Since a big part of my life includes physical activity, this presented a serious hindrance for me," says Bourn. His physician recommended and scheduled cardioversion, a procedure in which the heart is electrically shocked in an attempt to regulate its beat. He was also put on drugs to thin his blood and keep his heartbeat regular, but they had nasty side effects.

"For a time, my heart was beating normally. While biking, things seemed okay. It wasn't until I started training for another race that I knew my heart went out of rhythm again. Furthermore, I wasn't comfortable being on drugs that could negatively affect my eyesight, liver and lung capacity," he recalls. Bourn was having more bad days than good, and he was looking to reverse the trend. "I was beginning to lose hope that I could remain active into my 60s and beyond," he says.

Exploring other options

My area cardiologist agreed that ablation — a procedure in which the bad signals in the heart are cauterized — might be a good option. "I was referred to Mayo Clinic in April of 2003, and to me that's where my story of recovery begins," says Bourn.

"For Mr. Bourn, doing the procedure was a quality-of-life decision," says Paul Friedman, M.D., a cardiologist at Mayo Clinic in Rochester. "It was clear to me that he thrived on running and biking. It kept him healthy, and in good physical and mental condition."

To understand a normal heart rhythm, visualize dropping a stone into a pond. The water ripples out evenly in all directions. Likewise, a heart should have a regular, rhythmic beating pattern. In contrast, atrial fibrillation is more like throwing a handful of stones into a quiet pond — the waves collide and interact in a complex manner. "With atrial fibrillation, the heart's top chambers erratically quiver. They can beat 300 to 400 times per minute, while the bottom chambers (and pulse) may be as fast as 160 beats per minute," explains Dr. Friedman. "When this happens, people can feel exhausted. While they may be just sitting in a chair, their heart might be running a marathon."

A number of factors may trigger atrial fibrillation. "Irregularities in the autonomic nervous system, aging and high blood pressure may play a role," says Dr. Friedman. In some people, rapid electrical activity, most commonly from the pulmonary veins in the left atrium, discharges rapidly and leads to fibrillation.

Well documented reasons to treat atrial fibrillation include:

• Symptoms interfere with patient's preferred lifestyle.
• In many people, atrial fibrillation increases the risk for stroke.
• Bottom chambers (ventricles) of the heart may begin to weaken if the heart beats too rapidly for weeks or months without rest.

There are many treatment options for atrial fibrillation. "Since Mr. Bourn had not responded well to medicines, catheter ablation was considered," notes Dr. Friedman. "In this procedure, thin flexible tubes (catheters) are advanced from the leg veins to the heart under X-ray guidance. These are used to selectively cauterize the tissue responsible for arrhythmia." The success rate for the procedure varies depending on an individual's heart condition, but for many patients exceeds 75 percent.

Back in the race

Following his successful ablation procedure, Bourn resolved to ride 1,500 miles on his bike annually. He participates in the MS150, St. Paul Classic and Jesse James rides. One day he completed a "century," riding 100 miles between sunrise and sunset.

His runs have included the Duffy Shuffle in Eden Prairie, the Twin Cities Marathon and Maine's Annual Heritage Day Road Race. Bourn clocks more than 20 miles per week, for conditioning and for fun. "I enjoy runs in various surroundings, with different courses and participants," says Bourn.

"I will live longer and better because I stay in shape and include rigorous physical activity in my life," says Bourn. "And, I continually chide my younger co-workers to join me and become more active."

"I was thrilled that Frank and I had entered the same run — and that he ran farther than I did," says Dr. Friedman, who ran the 5K race in Rochester with his daughter. "It was very gratifying to see his improvement following the ablation."

"I wasn't really happy with my finish time," says Bourn, "I worked to knock off another 17 minutes and finish under two hours next time around. I have dreams of running in the Boston Marathon, but I'm not sure I can qualify. I do know one thing with absolute clarity ... a person should never give up hope until they've been to Mayo Clinic."