Dr. John Clark comforts patient Sandra Mullins after her cardioneuroablation procedure.
Sandra Mullins – a 15-year-old from Antioch, Tennessee – had fainting spells for a year and a half. She was heading toward a pacemaker – until that fateful day her mom found a cardioneuroablation (CNA) video online featuring Dr. John Clark, pediatric cardiologist and director of the Akron Children’s Pediatric Arrythmia Center.
Sandra’s parents, Jessica and Scott, took her to her pediatrician after one of the fainting episodes. Abnormal EKG results led them to an electrophysiologist, who recommended an implantable loop recorder to monitor Sandra’s heart activity and record abnormalities. “The loop recorder caught an instance when Sandra’s heart stopped for 10 seconds,” Jessica recalled. “The doctor diagnosed her with cardioinhibitory syncope – which is fainting caused by a quick drop in her heart rate – and said she may need a pacemaker if it continued happening.”
Searching for options
Jessica wasn’t thrilled about the idea of her teenager getting a pacemaker, so she started doing online research. She found Dr. Clark’s CNA video and wanted to learn more about the one-time, minimally invasive procedure that could save Sandra from a pacemaker. “I looked for other doctors closer to us, but I couldn’t find anyone who does CNA on kids,” she said. “After a lot of discussion with Scott, we set up a telehealth appointment with Dr. Clark. Sandra’s electrophysiologist in Tennessee also supported our decision to see Dr. Clark for the procedure.”
Sandra was on the path to a pacemaker, until her mom learned about cardioneuroablation at Akron Children’s.
Sandra was a strong CNA candidate for two reasons. “She had that documented, 10-second stop in her heart rate – and CNA would address that specifically,” Dr. Clark said. “Also, she was a candidate for a pacemaker. That’s an invasive surgery, and there are long-term complications associated with pacemakers in young people. CNA offered the possibility of stopping Sandra’s heart from quitting the way it did, while avoiding the complications and the invasion of a pacemaker.”
Dr. Clark reviewed Sandra’s tests from her Tennessee doctors. Sandra underwent more testing the day before the CNA procedure, and the family met with Dr. Clark. “He spent a lot of time with us and answered our questions,” Jessica said, “which helped us feel prepared for the next day.”
Procedure day
Before the procedure on Dec. 18, 2024, Sandra received a stuffed animal and a visit from an Akron Children’s child life specialist who explained what to expect. “Sandra tends to have a lot of anxiety around medical procedures, but everyone at Akron Children’s was great,” Jessica said.
For the CNA, Dr. Clark threaded wire catheters through the vein in Sandra’s right leg. He positioned the catheters inside Sandra’s heart and neck. “We simulate the vagus nerve in the neck, which makes the heart rate decrease,” he shared. “Then we cauterize, which means burn, the cluster of nerve cells in the heart to eliminate those irregular electrical signals.”
Dr. Clark stays focused as he performs Sandra’s heart procedure.
Sandra’s CNA procedure went even better than Dr. Clark expected. “Four primary areas of the heart are most responsive to nerve signals from the brain that tell the heart rate to slow down,” he explained. “We can cauterize 1-4 spots, and we do as many as necessary. We went through our usual steps with Sandra and did one burn in the most beneficial spot. We stimulated the vagus nerve again, and nothing. Her heart didn’t stop anymore.”
Usually, Dr. Clark cauterizes 2-3 areas. “I tested Sandra from every angle I could, and it was exactly the end point we shot for,” he said. “The data showed we were done with the procedure, but I wanted to get Jessica and Scott’s opinion. If they were in the Akron area, it would be easy to keep an eye on Sandra and go back in if needed. But her family came from Tennessee, so I wanted to make sure her parents were OK with my decision to cauterize only one area.”
Celebrating success
Dr. Clark says he has the best job on the planet. “I love the fact I have the training and experience that can help patients like Sandra from beyond northeast Ohio,” he said. “In a four-hour CNA procedure, kids’ hearts are fixed – and they don’t even need stitches. They get discharged the same day, and the parents can’t believe it. I love that I get to do that.”
Today, Sandra feels great and has no restrictions. She recently had a follow-up visit with her Tennessee electrophysiologist, who is happy with the CNA results.
Sandra is happier and healthier today, thanks to the care she received at Akron Children’s.
“As her parents, it was a tough decision to travel to another state for this procedure. But we wouldn’t change a thing,” Jessica said. “Since her procedure, Sandra’s mental health has vastly improved. She’s happier, healthier, and best of all, she didn’t have to get a pacemaker. We felt Sandra was in really good hands, and we’re very thankful to Dr. Clark and his team.”
Akron Children’s Heart Center treats kids and adults with heart arrhythmia conditions. For more information or to schedule an appointment, call 330-543-8521.
