McTominay diagnosed with arrhythmia, to undergo heart surgery after elevated indicators

Napoli club officials announced that McTominay will undergo heart surgery. According to The Athletic, McTominay was diagnosed with arrhythmia when he joined Napoli and has recently shown elevated indicators, necessitating surgery.

McTominay, a midfielder for Napoli and the Scotland national team, will undergo minimally invasive heart surgery next week and is expected to be sidelined for over a month.

The 27-year-old was substituted in the second half of Napoli's 1-2 loss to Como last weekend. The club officially confirmed that he suffers from a mild, benign arrhythmia requiring corrective surgery. Arrhythmia refers to a heartbeat that is too fast, too slow, or irregular, but McTominay is expected to return to play after the international break.

Following the announcement, he posted on social media: "Napoli, see you soon. I won't be gone for too long."

He is not the first active footballer to undergo heart surgery. Former Liverpool midfielder Lallana had corrective surgery for arrhythmia at age 16 and has since made over 500 first-team appearances. Portsmouth striker Colby Bishop returned to play after open-heart surgery to eliminate potential risks; former Brighton and Rangers defender Connor Goldson underwent open-heart surgery for an enlarged aortic root.

Eriksen, Blind, and Lockyer all had implantable cardioverter-defibrillators (ICDs) implanted and successfully returned to play. This device delivers an electric shock to defibrillate the heart if it detects life-threatening malignant arrhythmias.

McTominay's condition does not require major surgery. The Athletic consulted Professor Malhotra, a consultant in sports cardiology at Manchester Metropolitan University who provides medical support to British Cycling and several top sports teams including Manchester City and Manchester United, to explain how football screens for and manages cardiac conditions in players.

How does football screen for heart problems?

Cardiac screening is common in elite sports. Rugby League and the England and Wales Cricket Board also have their own screening programs, but England Football's screening system is the most comprehensive.

In 1995, 16-year-old Jon Marshall died suddenly from an undiagnosed arrhythmogenic right ventricular cardiomyopathy. This tragedy became a watershed moment—he was scheduled to sign with Everton the following day. The incident prompted the Professional Footballers' Association in England to launch a comprehensive screening program for all academy apprentices.

The program requires all academy apprentices to undergo two examinations: an electrocardiogram (ECG), which measures the heart's electrical activity and identifies abnormal rhythms; and an echocardiogram, which uses ultrasound to display the heart's structure and function in real time.

How common are these heart problems?

Professor Malhotra's research shows that elite footballers have a higher incidence of serious heart disease, with approximately one in 250 individuals affected. The charity Cardiac Risk in the Young (CRY) screens the general population aged 14-35 and finds that one in 300 people have a life-threatening heart condition.

Among footballers, approximately one in 50 experience minor heart problems. After surveying over 11,000 players, Professor Malhotra concluded that 75% of players diagnosed with severe conditions return to play after completing a full evaluation and undergoing corrective surgery.

Using ECG alone, the detection rate can be as high as 85%. Some studies show detection rates can be even higher for these heart conditions, often called "silent killers," which typically present no symptoms before onset.

Screening costs vary. ECG tests provided by charities like Cardiac Risk in the Young cost £75, while the standard market price is around £150; an echocardiogram costs several hundred pounds more.

Why is McTominay undergoing surgery now?

McTominay's arrhythmia is a hereditary condition that was detected before he joined Napoli in 2024. At that time, immediate surgery was not required, but recent wearable monitoring devices revealed abnormally elevated readings, and medical advice recommended he undergo surgery now.

With a relatively light fixture schedule ahead, Napoli expects him to return shortly after the international break.

Italian football has strict regulations regarding cardiac conditions. The sudden death of Perugia player Renato Curi during a match against Juventus in 1977, and the tragic death of Fiorentina defender Astori in 2018, have made Italy particularly vigilant about cardiac risks. In the latter case, the former head of sports medicine at Careggi University Hospital was convicted and received a one-year suspended sentence for manslaughter.

This is also why Danish midfielder Eriksen, after collapsing on the field at Euro 2020 and receiving a defibrillator implant, was unable to continue playing for Inter Milan in Italy.

What exactly is this surgery?

Professor Malhotra explained that arrhythmia is a general term for various heart rhythm disorders, and radiofrequency ablation surgery typically lasts between one and several hours.

According to the British Heart Foundation, cardiac arrhythmia ablation is a procedure that uses heat or cold energy to create tiny scars inside the heart, blocking abnormal electrical signals and restoring normal heart rhythm.

"The inside of the heart is like having its own set of traffic lights—our natural pacemaker—and sometimes it malfunctions. Ablation surgery is needed to ensure electrical signals travel normally along the main pathways," Professor Malhotra explained.

"I often use this analogy with players: the goal of the surgery is to maintain normal conduction of electrical signals along the main pathways within the heart, allowing it to contract synchronously. Sometimes collateral signals interfere with the main pathway, and ablation surgery eliminates this interference, restoring the heart's electrical activity to normal."

Will monitoring be required after returning to play?

Any player with heart disease or who has undergone heart surgery must pass Serie A's sports fitness assessment before returning to competition.

"A recovery period of two to four weeks is reasonable, but the return to training must be gradual—players cannot go full intensity on the first day," said Professor Malhotra.

"Be aware of groin complications, as the surgical catheter is inserted from there."

Professor Malhotra noted that even for minor heart surgery, the player's psychological recovery is often equally important.

"I am conducting relevant research, and while there are no complete statistics currently, this is a very critical factor. Based on clinical experience, players have concerns: how much intensity can I really push? Confidence slowly rebuilds as discomfort does not reappear over time.

The psychological aspect of returning to play is important but often underestimated. Even when medical professionals confirm an athlete can return, players inevitably wonder: how far can I push myself? Will the condition recur?

As training gradually resumes and exercise intensity increases without symptoms, confidence typically returns slowly. With young athletes, parents are often more anxious than the players themselves; players are focused on resuming the sport they have played since childhood.

For established professional players who may have started families, the mindset differs. Medical assessment results may be reassuring, but everyone's risk tolerance and attitude toward returning to play naturally vary."

He stated that the vast majority of players who undergo surgery receive post-operative monitoring. One of the most common methods is wearing a wireless wearable device affixed to the chest, which continuously monitors heart rate during sleep and exercise for up to 7 days or longer. Players also undergo treadmill or cycling stress tests.

What does this mean for Scotland?

McTominay will miss the international break in late September and early October.

This means new head coach Steve Clarke will be without a key player at the start of the Nations League. Scotland will play Switzerland, North Macedonia, and Slovenia twice. The team is developing a new high-intensity pressing style, and preparation without McTominay is far from ideal.

Although Scotland's World Cup campaign was disappointing, McTominay was a prominent figure in Scottish football before the tournament. A mural featuring his overhead kick goal against Denmark in World Cup qualifying was displayed opposite Hampden Park; he also appeared alongside singer Lewis Capaldi in Adidas' "Choose Scotland" advertising campaign.

In recent years, he has been Scotland's most consistent goalscorer, with 15 goals in 73 national team appearances. Scotland's forwards all play outside top-tier leagues, limiting attacking firepower.

Aston Villa midfielder John McGinn is another major attacking threat, having scored 21 goals for Scotland and serving as the primary creative force when the team returned to the World Cup. During McTominay's absence, McGinn will likely shoulder a heavier attacking burden.

AF's PC site is now live! Browse full news, comments, match details and stats on your computer. Visit: www.allfootballapp.com