Saved by seconds: Staff, AED rescue student in cardiac arrest

LEXINGTON, Ky. (Dec. 5, 2024) – For Annastasia Tipton of Ashland, Kentucky, Sept. 29, 2023 started off as a typical school day at Blazer High School. Classes, tests, gossip with friends — and no indication that the 14-year-old would be fighting for her life before the end of the day.

During gym class, Annastasia suddenly felt dizzy and lightheaded. With a racing feeling in her chest, she went to the school nurse, who noted that Annastasia’s pulse was dangerously high — 240 beats per minute. The nurse called Annastasia’s mom, Tiffany, and advised her to get Annastasia checked out by a doctor right away. On her way to the school, Tiffany got a second, more harrowing phone call.

“I got another call that Annastasia had collapsed in the office and was having what looked like a seizure,” Tiffany said. “When I got there, she was on the floor in the office, unconscious and struggling to breathe.”

Annastasia had gone into sudden cardiac arrest; her heart stopped beating, cutting off the blood flow to her brain and other vital organs. Fortunately, Annastasia’s school was equipped with an automated external defibrillator (AED) — and it was located right where she collapsed. School staff used it shock her heart back into rhythm. When emergency services arrived, she had to be shocked again before being transported to UK King’s Daughters.

Once she was more stable, she was soon transferred again to the pediatric intensive care unit at Cabell Huntington Hospital in West Virginia, where pediatric cardiologist Jeff Harris, M.D., noticed something unusual on Annastasia’s ECG. He consulted with Shaun Mohan, M.D., a pediatric electrophysiologist at the Kentucky Children’s Hospital (KCH) Joint Pediatric and Congenital Heart Program. The program is a collaboration with Cincinnati Children’s Hospital Medical Center that provides the full spectrum of cardiac care for Kentucky families and is one of the top pediatric cardiology programs in the country, according to U.S. News and World Report. 

Harris and Mohan recognized the abnormality right away as Wolff-Parkinson-White (WPW) syndrome, a rare congenital condition in which a person has an extra electrical pathway between the heart’s upper and lower chambers. This extra pathway bypasses the heart’s central electrical system, called the atrioventricular (AV) node, and can lead to episodes of supraventricular tachycardia (SVT) — the dangerously high heart rate Annastasia was experiencing. SVT can cause the upper or lower chambers of the heart to beat erratically, known as atrial or ventricular fibrillation, respectively. While atrial fibrillation can cause the symptoms Annastasia was experiencing — lightheadedness, dizziness — it was the ventricular fibrillation that led to her cardiac arrest.

WPW syndrome is relatively rare — Mohan estimates it effects roughly three out of every 1,000 individuals worldwide, and about three in every 10,000 with WPW syndrome are at risk for death by sudden cardiac arrest.

“As a pediatric electrophysiologist, I see about 30-40 cases per year; all ages from infants to school aged kids to teenagers,” said Mohan. “But rarely do they present in the manner that Annastasia did.”

For Tiffany, the news was overwhelming. Annastasia had always been outgoing and active, spending her free time practicing archery, as well as drawing, sewing and cosplaying. She had never been diagnosed with, or shown signs of, a heart condition; nor was there a family history of heart problems. Prior to her transfer to KCH, Annastasia spent a week at Cabell, where Harris and his team monitored her heart, brain function and vital signs. That week felt surreal to Tiffany, who spent every day in Annastasia’s room.

“We didn't really know what was wrong,” she said. “They were just trying to protect her brain function and let her body rest as much as possible. My best friend and I stayed in her hospital room, only leaving at midnight to go eat pie in the cafeteria downstairs. It became our little ritual to get me out of the room for a little bit each night.”

Once Annastasia was stable, she was transferred to KCH for treatment. Most patients who have a single cardiac arrest are considered to have a higher risk of a repeat arrest. One way to ensure WPW won’t lead to future incidents is to eliminate the extra electrical pathway through catheter ablation. Mohan and his team inserted a small tube in one of Annastasia’s veins and worked it all the way up to her heart. Using targeted radiofrequency energy, the area with the errant electrical pathway was destroyed. The procedure has an 85-95% success rate.

The prospect of a parent’s child having any kind of heart procedure is daunting, but Tiffany knew Annastasia was in good hands.

“Dr. Mohan was great,” she said. “He’s so smart and really personable and he really tries to connect with you so that you understand what's going on. His staff was helpful and kind as well.”

After a week at KCH, Annastasia was discharged. Aside from being excused from gym class for the rest of the school year, she has no restrictions on her activity. She follows up regularly at the KCH heart clinic in Ashland with pediatric cardiologist Louis I. Bezold, M.D. If, after two years from her ablation, she’s still symptom-free with no further heart issues, she will be discharged from long-term follow up care.

However, Annastasia does have one lingering side effect. Due to the lack of blood flow to her brain during the cardiac arrest, she has only a few memories of the incident and her time in any of the three hospitals where she was a patient for more than two weeks.

Back in Ashland, the administrators in Annastasia’s school district procured additional AEDs for her school; her proximity to an AED was a critical factor in her survival and recovery. While her chances of future incidents are low, Annastasia’s mother takes comfort in the fact that others at school will have quick access to the devices.

“It makes me so happy that the school took such a positive step forward towards their students’ health,” Tiffany said. “All schools should have multiple AEDs available to help save the lives of our precious children should something happen.”

Mohan is working toward that very goal. Through the nationwide program Project ADAM, a team from KCH has been conducting drills at schools in Fayette County, testing faculty on response time and procedures in the event of a cardiac arrest at school. Their goal is to ensure every school has the “Heartsafe” designation so that students like Annastasia have the best possible chance at survival and recovery should the unthinkable happen.

It was a serendipitous confluence of events that came together to ensure Annastasia is still here today. WPW is rare enough ­­— it’s even more uncommon for it to present for the first time in the form of cardiac arrest. Her school had an AED and a staff member trained to use it. The cardiologist at Cabell recognized the signs of WPW and referred her to KCH.

Even though Annastasia has no memory of any part of her ordeal, she recognizes how important it was for her to advocate for herself, listen to her body and to get help when she felt unwell. Just by going to the nurse’s office that during gym class, she effectively saved her own life.

Looking back on the terrifying ordeal, Tiffany still feels the weight she carried for Annastasia and her family, but recognizes that showing strength and bravery for her child is just as important as any medical intervention.

“Be brave,” she said. “They need that from you. You need that from you too. It's okay to cry. You need to feel your feelings too. Have faith. Know that your faith will help carry you through this unimaginably hard event in your life.”

***

Each year, more than 350,000 people experience out-of-hospital cardiac arrest in the U.S. and about 90% of them do not survive. One of the biggest determining factors of survival is the number of people in your community who know CPR. The more people around you who have CPR training, the more likely one will be around when you need it. Hands Only CPR takes two minutes to learn and, if performed immediately, can double or triple a cardiac arrest’s victim chance of survival.

Learn more about Project ADAM or to request AED training and Heartsafe designation for your school.