I do not use mine in clamshell mode only because I like the trackpad and keyboard. My officemate has a 2019 16" MBP and an Apple 4K monitor plus external keypad and mouse. She uses it in clamshell mode almost exclusively. She does all the graphic design work plus any After Effects projects so it gets heavy use. The battery is fine. She did the same with her previous laptop which was a 2015 15" MBP and it still works great - no battery issues.
They are designed to be used in clamshell mode. The way they remove heat is by venting out the back of the computer.