How would you feel if you could no longer do your favorite sports and activities? Unfortunately, there was a time when Nicholas “Nic” Solomon, 13, knew exactly how that felt.
The Tallahassee teen, a competitive martial artist ranked among the Top 10 in Florida for taekwondo, was sidelined from his passion after being diagnosed with supraventricular tachycardia (SVT) and Wolff-Parkinson-White (WPW) syndrome this past February at Wolfson Children’s Hospital of Jacksonville. Identified by pediatric cardiac electrophysiologist Sunita Ferns, MD, director of Pediatric and Adult Congenital Cardiac Electrophysiology at Wolfson Children’s, these conditions can cause an abnormally fast heartbeat as a result of an electrical short circuit in the heart.
A normal heart rate is between 70 and 110 beats a minute. During SVT, the heart can beat at 250 to 300 times per minute, causing lightheadedness and chest pain or discomfort. With WPW syndrome, a congenital heart problem and rare form of SVT, patients can experience a life-threatening arrhythmia that can lead to sudden cardiac arrest.
“The diagnosis was a big blow,” said Dolly Solomon, Nic’s mom. “He couldn’t exercise or compete, which is so difficult for an athlete.”
A family challenge
The diagnosis was equally hard for Nic’s mom. “Nic appeared to be so healthy,” Dolly said. “I didn’t want to believe anything was wrong with my son’s heart. I wanted everything to be okay.”
It all started two years ago when Nic began experiencing episodes of heart palpitations while exercising. In most cases, a rapid heartbeat isn’t life-threatening, but it shouldn’t be ignored as serious heart problems can occur. Nic’s pediatrician recommended consulting with pediatric cardiologist Justin “Mac” Vining, MD, at Wolfson Children's Specialty Center at Tallahassee Memorial HealthCare. Part of a longstanding partnership between Wolfson Children’s Hospital and Tallahassee Memorial HealthCare (TMH), the Specialty Center is designed to give Tallahassee-area families like Nic’s access to pediatric specialists close to home, as well as to offer a streamlined continuum of care should they need advanced pediatric intervention at Wolfson Children’s in Jacksonville.
“Since Nic is highly competitive in taekwondo, identifying the true nature of the chest pain was important,” said Dr. Vining. “In Nic’s case, there were several different possibilities. Taekwondo is a contact sport, so musculoskeletal injury is a possibility. He gets up before 7 am every morning to train, and musculoskeletal injuries are common in young athletes who lift weights. He has a history of asthma and uses albuterol, which can trigger chest pain in kids and teens. I chose to take a complete approach to identify the true cause of his symptoms.”
Dr. Vining ordered cardiac testing, including an echocardiogram and an electrocardiogram, commonly referred to as an EKG or ECG. While often used in conjunction and complementary to each other, an echocardiogram provides an ultrasound of the heart and an EKG records the heart’s electrical activity. After reviewing the results, Dr. Vining recommended an initial period of observation.
Nic’s rapid heart palpitations continued and when the intensity increased, he returned to Dr. Vining for further examination. After monitoring the activity of Nic’s heart, Dr. Vining referred Nic and his family to Dr. Ferns at Wolfson Children’s Hospital of Jacksonville. In addition to her board certifications in pediatrics and pediatric cardiology, Dr. Ferns is one of the few physicians in North America to be trained and board-certified in pediatric electrophysiology and adult congenital heart disease.
During Nic’s first appointment in Jacksonville, Dr. Ferns reviewed his history and conducted non-invasive cardiac testing that confirmed a diagnosis of WPW syndrome and SVT.
"The WPW pattern on his EKG was very subtle, which is why it had not been detected until he saw us in our electrophysiology clinic,” said Dr. Ferns. “In some rare situations, WPW can cause a rhythm disturbance leading to cardiac arrest, which is very serious. We needed to conduct an electrical catheter study and an ablation procedure to locate the extra electrical connection and correct his heart arrhythmia."
Healing Nic’s heart
In order to avoid the risk of cardiac arrest, Nic had to refrain from exercise and sports activities until after his procedure in March. The exertion from sports and high-intensity activities can send a high level of adrenaline circulating throughout the body, which is the danger for young athletes with WPW like Nic.
Dolly, along with Nic’s father, Mark, brought Nic to Wolfson Children’s from Tallahassee on the morning of his surgery. Due to the COVID-19 pandemic, visitation restrictions allowed only one parent to accompany Nic in the hospital. Dolly went in with him.
The procedure in the Wolfson Children’s Cardiac Catheterization Laboratory took approximately three-and-a-half hours. During Nic’s ablation, Dr. Ferns advanced catheters through a vein in the groin and into the heart. Electrical signals from the catheters helped locate the extra electrical connection, which was then eliminated.
In most cases, an ablation is an outpatient procedure, but due to the location of the abnormal connection in Nic’s heart, he spent a period of overnight observation in the Cardiovascular ICU (CVICU) at Wolfson Children’s Hospital before returning home to Tallahassee.
“Everyone at Wolfson Children’s Hospital was good to us,” said Dolly. “We were blessed to be in the care of those doctors and nurses. I have so much gratitude.”
Two months after his procedure, Nic went for his follow-up appointment with Dr. Vining in Tallahassee and was deemed in perfect health. He resumed his athletic training in September.
“Nic’s condition was treated and he can lead a normal, healthy life,” said Dolly.
Dr. Ferns recommended a heart health screening examination for Nic’s 16-year-old brother, Julian, even though he hadn’t had any symptoms. Julian is also an active teen who is ranked among the top martial artists in Florida. Fortunately, Dr. Vining was able to rule out any heart abnormalities in Julian, a relief to the Solomon family.
“Screening for conditions is particularly useful if you can modify the course of the disease or its impact,” said Dr. Ferns. “Conditions like WPW that are readily detected on screening need to be taken very seriously because, in a small percentage of cases, the first symptom can be a cardiac arrest. Early detection of electric abnormalities in the heart through screening can help us intervene. In Nic’s case, his condition was completely reversed with the ablation procedure. Nic no longer has heart disease.”
The C. Herman and Mary Virginia Terry Heart Institute at Wolfson Children's Hospital provides expert treatment from pediatric specialists for a wide range of heart conditions, from rhythm disorders to congenital heart defects. To learn more, call 904.202.8550.