Lionel Richie’s Afib Ablation Draws Attention to the Heart Rhythm Disorder

Lionel Richie is reportedly recovering after undergoing an atrial fibrillation (Afib) ablation earlier this week.

The singer and “American Idol” judge, age 77, is said to have had a successful Afib ablation after complaining of feeling “dizzy” onstage in June and later getting tests done for cardiac issues in August, as reported by TMZ.

Afib is the most common arrhythmia and puts affected individuals at risk of blood clots, stroke, heart failure, and other heart-related complications. While Afib may be asymptomatic, common symptoms include palpitations, fatigue, and shortness of breath.

Treatments can include heart rhythm- or rate-controlling medications, lifestyle management, cardioversion, and cardiac ablation. Afib ablation most commonly involves minimally invasive catheterization in an electrophysiology lab and is centered on pulmonary vein isolation (PVI) for preventing atrial arrhythmia recurrence.

It has not been disclosed what type of Afib Richie has or what modality of cardiac ablation he underwent.

Cardiac ablation is established as a first-line treatment for paroxysmal Afib (in which normal rhythm returns within 7 days); guidelines recommend a trial of antiarrhythmic drugs before catheter ablation for persistent Afib (when a single episode lasts more than 7 days), though the procedure is increasingly used as first-line therapy in the real world.

In recent years, advances in ablation techniques have introduced new technologies for achieving durable PVI. The FDA approved the first system for pulsed field ablation (PFA) of paroxysmal and persistent Afib in 2023, marking a new chapter beyond conventional radiofrequency and cryoablation techniques that rely on thermal damage to isolate aberrant electrical pathways and restore sinus rhythm.

PFA technology is supposed to be safer, as its non-thermal mechanism reduces the risk of unintended damage to nearby collateral structures. PFA utilizes microsecond-scale, high-voltage electrical fields to damage cell membranes and thus achieve PVI.

The technology was bolstered by this year’s randomized AVANT GUARD trial, which showed that first-line treatment with PFA reduced the risk of recurrence of atrial arrhythmia among patients with persistent Afib — a group that has conventionally had worse procedural outcomes with thermal-based ablation techniques than peers with paroxysmal Afib.

The new PFA systems have nevertheless prompted concerns about their own unique safety issues: Real-world data showed that early cases were associated with more markers of non-target myocardial injury, hemolysis, acute kidney injury, and global cardiac dysfunction compared with conventional radiofrequency ablation. Experts expect that newer device designs are expected to mitigate these risks.

Given Richie’s time off for recovery, three of his scheduled performances on the Sing a Song All Night Long Tour with Earth, Wind & Fire are now cancelled. He is still scheduled to take the stage for a 6-night concert series in Las Vegas in October and November.