Music or Podcasts While Running for Enhanced Longevity? Baby’s on Fire versus Watchman Clots

The skeptical cardiologist switched to running as his primary form of cardio exercise in 2014 after reading about a prospective longitudinal cohort study at the Cooper Clinic in Dallas, Texas, which. looked at data from a group of 55,137 adults on whom they had information on running or jogging activity during the previous 3 months. Those individuals who described themselves as having done any running in the last 3 months had a 30% lower risk of all-cause mortality and a 45% lower cardiovascular mortality

At the time I felt the study was not definitive, but food for thought. Evidently, it got me thinking so much that I began running regularly (despite my previous dislike of running).

By 2016 I was running to music while running and wrote a post on matching music tempo to running tempo. I recently revisited that post and updated it with my future self editorial comments.

I mention in that post that there is a body of scientific literature related to music and exercise, and the vast majority of it seems to come from one man,  Dr Costas Karageorghis at Brunel University in London, an expert on the effects of music on exercise.  In his 2010 book, Inside Sport Psychology, he claims that listening to music while running can boost performance by up to 15%.

I also made the point that running as exercise means less minutes exercising weekly to achieve what is optimal for cardiovascular health. If you engage in vigorous exercise such as running or jogging, cycling fast or singles tennis, you only need to achieve 75 minutes per week. Moderate exercise such as walking or elliptical work-outs requires 150 minutes/week.

For the most part, these days, I don’t run while listening to music. I listen to podcasts or listen to nothing but the sounds of the neighborhood. Often while listening to nothing, seemingly brilliant ideas pop into my head, solving long-standing dilemmas or puzzles.

Learning While Running: Podcasts

One podcast I have found particularly enjoyable during my runs is This Week in cardiology (TWIC) by my old cardiology partner and now social media giant, John Mandrola.

These 20 minute, weekly gems consist of Mandrola giving us his take on the latest studies and developments in cardiology. Lately, these episodes typically begin with some insightful, pithy discussion on COVID-19 which, of course, everyone is interested in.

I really appreciate Mandrola’s conservative approach to new procedures and treatments along with his detailed breakdowns of important trials. He is clearly an independent and unbiased thinker which is rare in this space. Most proceduralists (Mandrola is an electrophysiologist) are heavily biased toward whatever procedure they do, Mandrola consistently presents a balanced perspective.

It is not uncommon for him to disagree with a procedure that his EP colleagues strongly embrace. For example, in the august 20 TWIC he has a very thoughtful update and critique of catheter-based left atrial appendage closure. The Watchman device has been heavily promoted to cardiologists as an alternative to anticoagulant therapy in those at high risk of bleeding based on small trials showing non-inferiority to warfarin therapy. Of course, newer oral anticoagulant drugs like apixaban (Eliquis) are superior to warfarin in both efficacy in preventing strokes and safety with bleeding risks similar to that of baby aspirin which is required long term post-Watchman.

Personally, I’ve never referred a patient for the Watchman due to many of the concerns Mandrola expresses.

There is no transcript of the TWIC podcasts (that I can find) which would be a really nice resource however an accompanying list of references (see below) is very useful:

3 – Left Atrial Appendage Closure

– FDA Approves Abbott’s Amplatzer Amulet for Atrial Fibrillation

– Chronic Kidney Disease Tied to Worse LAAO Outcomes

– The Association of Chronic Kidney Disease With Outcomes Following Percutaneous Left Atrial Appendage Closure

What podcasts do you recommend?

Cadpostingly Yours,



19 thoughts on “Music or Podcasts While Running for Enhanced Longevity? Baby’s on Fire versus Watchman Clots”

  1. Dr Pearson

    As a runner I would love it if you were able to write a short article on safe or target heart rates for runners, and how to best determine them if there is such a thing. I use a device to track my rate and I’m in my 50s age wise. Various web sites provide formula for a safe rate based on ones age and it would be great to hear your insights.



  2. Dr. Pearson, what is the reasoning behind having a 5 hour ablation so not to have to take blood thinners? Do you suggest that for me following a recent successful ablation?

    • Guidelines do not recommend stopping blood thinners after Afib ablation irrespective of the duration, the method or any other measurable factor.
      Dr P

    • Chris, as I mentioned upstream, I still take Eliquis in spite of having zero episodes of Afib for well over 2 years simply because I’m not 110% sure that my ticker has decided to behave itself forever (and my EP hasn’t suggested I’m wrong)……..and I think I’d feel the same if I’d had an ablation. My rationale for wanting the Afib gone was to avoid a descent into heart failure as much as stroke prevention.


  3. In my forties, I regularly ran, but then encountered IT band problems, plantar fasciitis, and finally knee surgery.

    I gave it all up for about 15 years, but have now started sprints, on grass, at a soccer field close to my house. I do old-man sprints up the field, then walk down. Repeat.

    I get a great workout, and I can do it every day. No soreness, no joint issues (my knees have even improved, when coupled with basic squat exercises.)

    Like another poster here, I really like grass or other forgiving surfaces.

    Finally, I value the quiet time – no music, no podcast voices. Time to think, process ideas and focus on the movement.

    Thank you for your posts!

  4. Don’t use music etc for outdoor running……I usually run alone, early mornings and feel the need to stay alert (rattlesnakes and other wildlife being uppermost in my mind)

    However, for the best part of the past 2 years I’ve been doing a lot of zone 2 conditioning on the treadmill/peloton and I use either the training programmes in these devices or podcasts. I subscribe to Peter Attia’s podcasts and, although he’s a bit too focused on biohacking for my tastes, he does interview some excellent guests interspersed between the hucksters (I’ll mention no names). I also give a thumbs-up to Ross Tucker’s Science of Sport (been a long-time fan of the old website for years) and Vincent Racaniello on This Week in Virology……although I usually have to focus too much here to run safely at speed on the treadmill.

    After a move from the East Coast (sea level) to Colorado (and an altitude of just over 6000ft) 5 years ago I’ve struggled with the effects of altitude on my training… every other “transplant” in my local running club…….and then Afib!!! Got my first 10k since the move coming up next month unless a spike in Covid alters my plans.


    • No rattlesnakes here but when running without airpods, despite my ruminations, I am more likely to hear the approach from behind of the deadly automobile.
      Don’t get me started on Zone 2 and Attia’s podcasts. I’ve been following Attia since I dove into keto and have a subscription to his podcasts. Lately, it is getting very hard to separate the wheat from the chaff.
      I don’t envy his patients as I think they are being over tested and over supplemented.
      In particular, his current obsession with CGM and fasting I think lacks scientific support.
      His podcast with Phil Maffetone and his frequent ramblings on Zone 2 are worthy of a TSC post.
      Hopefully, you will have no more AFib!
      dr P

      • Well, I find myself wondering if Peter Attia actually has that many patients outside of the one or two he mentions……who aren’t really that sick anyway. Sounds to me like he hasn’t done much by way of actual doctoring once he left his residency/fellowship?? I mean, McKinsey & Co., NuSi fundraising and traveling hither and yon for his blog making doesn’t exactly lend itself to developing clinical expertise, does it?

        Re: the Afib……

        I’ve been following John Mandrola for years……long before I developed Afib and I first read an article by him in Runner’s World (about the dangers of overtraining) Looking back over the whole of his website, it almost reads to me like a time line of the change in focus on Afib management over the last decade or so, no? I’m one of those people who don’t fit into the Usual Suspects sieve……don’t overtrain, never been overweight or sedentary, no high BP, not a binge drinker, no structural anomolies etc. etc But I am 68. Fortunately, my EP is equally enlightened and didn’t push the ablation as my episodes were infrequent and short duration on my combo of sotolol and eliquis. However, something I noticed via my garmin wearable is that a single glass of wine or a G&T would have my resting HR elevated by about 10 bpm for 2 or 3 days!! FWIW, I’ve always been a cheap date in that respect and especially so at altitude so I got to wondering if “moderate” alcohol intake was the equivalent of binge drinking for me and that I was suffering a version of Saturday Night Arrhythmia ;) Husband sort of pooh-poohed the notion (he’s a hepatologist!) but I decided to cut out alcohol just to see after Christmas of 2018…….and not a single episode since!! This is in spite of tapering off my sotolol towards the end of that year. This was almost a necessity as we took a trip back to England and within a couple of days, my resting HR was down in the very low 40s and I was getting a few ectopic beats. Not confident enough of total “cure” yet, mind so I still take my eliquis and a magnesium supplement (not at the same time)


    • I consulted a local cardiologist when I visited Vail, elevation 6000 feet for the village, and we regularly skied at higher altitudes. I think over 10,000 feet but not absolutely sure.

      My Kardia Apple Watch picked up some irregularities, which were sent off for their consultant analysis. PVCs confirmed, so off to the Vail cardiologist.

      The cardiologist advised that living at higher altitude typically exacerbated existing cardiac issues, and that these problems were poorly documented.

      He said he has many clients who visit Vail regularly, and who require massive adjustments to their medication dosage while they are at altitude.

      We have sold our time shares in Vail, with great regret after many years of joyful family holidays. We now ski in Japan, where the altitude is much lower. No alcohol and no further arrhythmias, so far so good.

      I use the Apple Watch 6 ECG to screen any perceived arrhythmia, which is very convenient. Any alerts are then checked with Kardia.

  5. I too enjoy Dr. Mandrola’s articles and his independent streak. Like Mandrola, I’m a cyclist. My knees don’t like running, and cycling is more comfortable (as long as I stay off the pavement). Getting back to riding after a radical prostatectomy has been an adjustment. I can’t really listen to anything while riding–can’t chance the distraction. When I rode with my club, I would sometimes sing–one reason I mostly ride alone these days.

    • Steven,
      I agree that listening to stuff while riding increases the risk of an accident. Despite that I have done it on a number of occasions.
      Most recently I was riding along the route from my house to work listening to a podcast when I suddenly realized that I was only hearing it in one ear. Sure enough, when I reached up my left airpod was missing. This is not the first time I have lost an airpod during a bike ride, I did the same thing on a ride to forest Park two years ago but didn’t learn my lesson. a year ago despite retracing my route I never found the airpod. This time, however, after back tracking over my route i found the rogue airpod lying in the middle of the street!
      I haven’t used them on a bike ride since. My wife tells me there are accessories one can purchase to keep them shackled should they decide to silently depart your ear.
      Dr. P

  6. What is the maximum number of times a person should undergo ablation? Do ablations cause permanent scarring within the heart? If so, is this bad? I’m having my third ablation at the end of September.

    • Concerning ablations, I had an ablation for atrial flutter that worked. Several years later I started having intermittent atrial fibrillation. I didn’t want to take blood thinners so I underwent a 5 hour ablation at Lahey Health near Boston. That was 5 years ago and I have been in NSR ever since. The key to successful ablation is having a top electrophysiologist physician perform it. I had Dr. Silver and he is the best. To do a successful ablation you need high tech mapping. It’s a very complex procedure requiring top of the line high-tech equipment.

      • docww,
        There is definitely a learning curve with ablation and as with any procedure or surgery there are going to be operators who perform high on the bell curve and low on the curve. For the average patient, sorting out where the EP that they were referred to sits on that curve of performance is nearly impossible.
        It would be great if we had statistics for each EP doctor in practice listing numbers of procedures , success rate, and complication rate. For the most part, this is impossible information to obtain.
        Dr P

    • Jon,
      This is somewhat off-topic and quite a difficult question to answer.
      When I’ve reviewed this with my patients I tell them that the success rate is lower and the complication rate higher with each successive ablation. Hopefully, you have had a good discussion with your EP on the risks and benefits of a third ablation.
      Dr P

  7. I also run faster when listening to music, specifically to Little Richard or The Brian Setzer Orchestra.

    One thing I would add is, try not to run primarily on pavement. I am 65 and do all my running on paths (or grass while playing Ultimate Frisbee) and have zero joint issues whereas everyone — everyone — my age I know who run regularly on pavement sort of assume that joint discomfort/pain is part of aging.

    • Interesting! it has always made sense to me that I would be better of running on a surface which has more give than asphalt or concerete.
      What is the composition of the running paths you seek?
      In Forest Park, where I ride my bike I note that not infrequently runners have chosen to run on my bike path and ignore the designated pedestrian paths which run parallel.
      Dr P

  8. I enjoyed today’s post about running. I used to be a pretty good 880 runner. Several times I ran against Jim Ryan (he won). In college I led off our 2 mile relay team. I was bigger than most half miles so the coach had me lead off. At the big meets like the Kansas Relays, they had 3 teams in each lane. My coach told me: “When the gun goes off, I want to see two runners on their ass on the track”. I did my job fairly well and earned the nickname “Doc elbows”. I new have severe DDD in my back so I can’t run. I just got off an hour on the treadmill and I walk at about 4 MPH and do some weight work. My dear mother had Alzheimer’s disease at my age and with a 7-year-old daughter, I can’t afford to go there so it’s healthy eating and exercise every day!

    • docww.
      I’m not sure I understand the advice of your coach. Were you supposed to attack the opposing runners? With your elbows???
      Track and Field in Kansas must have been quite interesting!
      Dr P


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