I agree to trust in his doctors but this isn't an easy issue at all. There is little comparative literature or guidelines for managing atrial fibrillation in athletes. I want him to return but the risk of a repeat emergency is present.

There are many "ifs" to consider and if his team feels they can safely control ventricular rhythm, decrease risk of thromboembolism/stroke and other complications, and maintain normal sinus rhythm (this is the least needed of the 3) then I'm all for it. He's being managed by Cleveland Clinic and UTSW which does open opportunity for experimental/new treatments which would definitely give him the absolute best chance at returning. I also don't have 100% information as the doctors do so it may be better or worse than what I can guess.

Ablation is about 70-80% effective after one (only 50-70 if chronic though), and 85-90% for two at one year. An implanted device is also an option to treat a-fib, may be needed after Cox-Maze procedure due to the procedure itself or sinus node problems, and is used post ablation when ventricular rate control is needed. I don't know why he has it but it's a good sign they are discussing removing it. It's also a good sign that he has been able to skate consistently as that tests his heart.

Another big question is what level of anticoagulant and antiplatelet therapy is needed to prevent stroke as that is one of the biggest complications faced (others include heart failure, heart attack, death, hypotension, bradycardia). If his CHADS2 score (nifty tool that helps evaluate stroke risk) is low he may only need Aspirin and would be able to play.

I hope he returns. They could definitely monitor his heart rhythm as they did before and with dedicated team doctors he's got better and more rapid care than most if problems arise. Precautions such as having an AED by the bench and all staff CPR certified are simple measures that appear already in place and would benefit any player.

If his ablation was successful and he's able to increase his exercise intensity without problems over the summer I could definitely see him getting the green light to return.

I'm a nurse practitioner and medically manage A-fib patients, but he's with a medical team that helps write the guidelines we use. I'm fascinated by his treatment and if he returns to play it could have benefit to others. I'm also glad I'm not the one making the decision.