Flyers go without Knuble

-- For SLAM! Sports

, Last Updated: 5:10 PM ET

WASHINGTON, D.C. -- Less than a week before the start of the regular season, the Philadelphia Flyers are without the services of forward Mike Knuble, one of their key additions following the 2003-04 season.

Knuble experienced an episode of atrial fibrillation, an abnormal heart rhythm that negatively impacts the mechanical functioning of the heart.

"On his first two shifts (in Friday night's game against the New Jersey Devils) he had no-brainers and missed," said Flyers head coach Ken Hitchcock.

"After the shift where he missed the wide-open net, he came back to the bench and went right to the locker room."

Paired with rookie Mike Richards and Jon Sim on the Flyers top-scoring line (10 goals and 15 assists), Knuble sets the table for his two natural-scoring linemates.

"Everything is back to normal," Knuble told the Philadelphia Inquirer. "I had an atrial (fibrillation). "What happens is the top portion of the heart gets out of rhythm."

"When it happened to me on the ice, I guess my heart got up to 160-170 beats, and I just felt I couldn't keep up with the pace," said Knuble. "I felt out of step out there."

Atrial fibrillation is the most common dysrhythmia (abnormal heart rhythm) requiring treatment, affecting approximately 2.2 million Americans and is among the most important medical causes of disqualification in athletes.

Some dysrhythmias are seen with a three times higher frequency among athletes as compared with similarly-aged sedentary individuals.

According to the July, 2005 issue of Clinics in Sports Medicine, structural changes or remodeling of the heart, especially the left atrium (upper chamber) occurs in approximately 20% of competitive athletes, particularly in swimmers, cyclists, and cross-country skiers.

"In Knuble's case, it's a combination of stressors and caffeine, nothing that's not uncontrollable."

"This isn't something where you feel pain or anything," Knuble told the Inquirer.

"A lot of people live with this every day. Some of them don't even know they have it."

The 26th annual Bethesda Conference Task Force recommended that athletes be allowed to compete in competitive, strenuous activity if they have no evidence of structural heart disease and, with or without drug treatment, maintain a pulse rate comparable to that expected during physical activity.

The Bethesda recommendations also apply to recreational athletes.

"As an athlete, it's more of an annoyance than anything else," Knuble told the Inquirer. "

"You learn to live with it like I have."

According to Hitchcock, Knuble has had episodes of atrial fibrillation "for the last 10-12 years," adding that "it's a little scary when you start hearing heart palpitations."

Hitchcock added that Knuble will be re-examined on Monday by team physicians and that he is expected to re-join the team at that time.


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