Teen Helps Electrophysiologists Cure His Arrhythmia

Stanford Medicine Children’s Health’s vast experience with ablation procedures makes a difference in Eian’s life

Eian Long is a young man who moves to his own drumbeat. He loves math and physics, and he has an uncanny ability to remember facts, especially those that relate to sports. His smarts and skills helped him become a top Roblox player, racking up more points than most of the platform’s millions of users.

“We call him ESPN because you can ask him anything about sports and he knows the answers,” says his dad, Brandon. “You don’t have to look up—just ask Eian.”

Recently, the 16-year-old used his exceptional ability to think logically and stay determined to help his doctors pinpoint his heart problem and safely cure it.

Discovering an abnormal heart rhythm

A few years back during an annual well-child check, Eian’s pediatrician noticed an abnormal heart rhythm. “It was a complete surprise to us. He didn’t have any symptoms,” says his mom, Price.

Eian was sent to a cardiologist for further testing. He received several tests, including different types of echocardiograms, before being diagnosed with ventricular tachycardia , a type of arrhythmia. An arrhythmia is an abnormal heartbeat, and tachycardia means the heart is beating extra-fast.

“At first, doctors thought he might be having episodes of fast heartbeats just now and then, but the monitor showed that his heart was doing it all of the time,” Price says. “It was scary because the heart can get tired. His tachycardia was silent, but it could have had big consequences.”

At the time, the Air Force family of five lived in New Jersey. Once they moved due to military orders to Roseville, California, they transferred Eian’s care to Stanford Medicine Children’s Health’s Pediatric Electrophysiology and Arrhythmia Program. There, they met Scott Ceresnak, MD, director of the program, and other members of the team.

Electrophysiologists are specialized cardiologists who treat arrhythmias with medicine and/or minimally invasive procedures. The Pediatric Electrophysiology and Arrhythmia care team at Stanford Children’s consistently performs a high number of arrhythmia procedures each year with a 96% success rate, which is above the national average.

Further testing revealed that Eian did not have a structural heart problem or genetic reason for his tachycardia.

Considering ablation for arrhythmia

The Stanford Children’s electrophysiology team discussed treatment options with Eian and his parents, which included trying medication to control the arrhythmia or ablation.

“It’s Eian’s heart, and we wanted him to decide. We appreciated how Stanford Children’s included him and had him make the decision,” Brandon says.

With ablation, an electrophysiologist places a catheter (a flexible long wire) in a major blood vessel (often in the leg) to travel up to the heart. Using advanced mapping systems, doctors locate the abnormal tissue and use radio waves to burn it or use cryoenergy to freeze it. While ablation is safe and minimally invasive, it is still a procedure. Logically, Eian wanted to try medication first.

“We tried several medications, but none of them worked to control his rhythm. His arrhythmia was severe, with 25% of his heartbeats being abnormal and numerous runs of ventricular tachycardia,” says Dr. Ceresnak.

Over time, Dr. Ceresnak noticed Eian’s heart function starting to deteriorate. This concerned him because uncontrolled tachycardia can eventually lead to heart failure, and Eian’s heart was not squeezing as well as it should. That was when he and the family revisited the idea of ablation. This time, Eian was ready to say yes.

Choosing the hard road: Staying awake during ablation

Once he decided to have the ablation, Eian was all in. “Eian likes to understand a problem, come up with a solution, and see it through,” Price says. Because of his grit and determination, Eian did something that many children won’t do—stay awake during the procedure. Most kids choose to be sedated because the procedure, while not painful, can be hours long. That’s a lot of sitting still with a team of doctors around you.

“With sedation, extra beats can also go to sleep, so it can be harder to locate the heart tissue that is generating the arrhythmia,” Dr. Ceresnak says. “Eian decided he wanted to stay awake to keep the extra beats going and help me find the location. And it helped, no question.”

Eian stayed awake for the entire three-hour procedure. While he felt some sensations, he did not feel pain. He handled it like a champ, staying still and expressing his needs as they went along.

“Eian was so calm, cool, and collected. I’m so proud of how he decided to help the doctor, and how he did his best,” Brandon says.

After the successful procedure, Dr. Ceresnak gave Eian a little twilight anesthesia to let him rest.

“He woke up panicked and said, ‘I’m sorry I fell asleep! I tried so hard.’ He was relieved to hear he had done it,” Price says.

Locating tachycardia in a dangerous, rare spot

Eian’s tachycardia was in an unusual area of the central heart called the coronary cusp, making the ablation more challenging than most. The coronary cusp is located on the aortic valve (the valve that controls blood flow from the main heart artery to the body). By being awake, Eian helped his doctors see the electrical activity in the area and home in to treat the exact right spot.

“Having tachycardia in the coronary cusp is rare and can be serious, as in Eian’s case, it led to the heart not functioning as it should,” Dr. Ceresnak says. Dr. Ceresnak and Stanford Children’s were part of a multicenter study that investigated ablation of the aortic cusp, which includes the coronary cusp.

The team proceeded with extreme caution. Navigational technology was used to create a 3-D map of Eian’s heart to identify electrical signals. Kyong-Jin Lee, MD, pediatric cardiologist with Pediatric Cardiac Catheterization and Interventional Cardiology, performed an angiogram to take pictures of Eian’s coronary arteries so that Dr. Ceresnak could steer clear of them. They are just millimeters away, and disturbance to them could permanently damage Eian’s heart. Heather Giacone, MD, electrophysiologist, joined Dr. Ceresnak for the ablation procedure.

“That’s the advantage of having an expert multidisciplinary team working together to handle these challenging cases,” Dr. Ceresnak says.

Stopping Eian’s tachycardia in its tracks

After the procedure, Price asked Eian how his heart felt. His answer said it all.

“He put his hand on his heart, took a deep breath, and said, ‘My heart is slow.’ It was exactly what we wanted to hear,” Price says.

Since the ablation, Eian’s tachycardia has been gone. There isn’t even a blip on the monitors.

“After the ablation, I was thrilled to see that his extra heartbeats went from 25% to zero. Everyone has some extra beats, so I was surprised to see he had zero,” says Dr. Ceresnak.

Dr. Ceresnak regularly checks Eian’s heart with a Holter heart monitor. For the past six months, he has gotten the same reading: zero tachycardia.

Usually, if tachycardia is going to recur, it happens early on. Dr. Ceresnak is fairly certain that Eian is cured and will have no lifelong heart problems.

“The beauty of the ablation procedure is that you come in for it and go home on the same day, and there’s a high chance that you are cured,” says Dr. Ceresnak. “It’s safe, low-risk, and high-reward.”

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