Arrhythmia in Children

Arrhythmia in Children

What is an arrhythmia?

An arrhythmia is any modification in the routine, even rhythm of the heartbeat. If your child has an arrhythmia, his/her heart may beat too quick or too slow, or it might avoid a beat or have extra beats. An arrhythmia may result from a physical condition– such as a heart defect– or in action to outside elements, such as a fever, infection, and certain medications. Even weeping and playing can quickly change a child’s heart rate.

The majority of arrhythmias are harmless, however some can be serious and even dangerous. If your child’s heart beats too fast (a condition referred to as tachycardia), or too sluggish (bradycardia), it may affect the heart’s ability to pump blood effectively to the remainder of the body. Irregular blood circulation can harm organs, consisting of the kidneys, liver, heart, and brain.

The heart typically beats in a consistent pattern, but an arrhythmia can make it beat too gradually, too rapidly, or irregularly. This erratic pumping can lead to a range of symptoms, including tiredness, lightheadedness, and chest pain.

How does an arrhythmia occur?

The pumping action of the heart is powered by an electrical pathway that goes through the nerves in the walls of the heart. With each heartbeat, an electrical signal is created and takes a trip from the top of the heart to the bottom.

The signal starts in a group of cells in the right atrium (the upper right chamber of the heart) called the sinoatrial node (SA node). From there, the signal takes a trip through unique paths to promote the right and left atria, causing them to contract and send out blood into the ventricles (the bottom chambers of the heart).

The current continues through its circuit to another group of cells called the atrioventricular node (AV node), which is in between the atria and the ventricles. From there, the electric current moves on to another path called the bundle of His, where the signal branch off to stimulate the right and left ventricles, causing them to contract and send out blood to the lungs and the rest of the body.

When the circuit is working effectively, the heart beats at a routine, smooth speed. When something interrupts the circuit, the heartbeat can become irregular, and an arrhythmia happens.

Types of arrhythmias

There are lots of types of arrhythmias, which can organized into three general classifications: supraventricular (atrial) arrhythmias, ventricular arrhythmias, and bradyarrhythmias.

Atrial arrhythmias in children consist of:

  • Premature atrial contractions (PACs)– early beats that start in the atria
  • Supraventricular tachycardia (SVT)– a fast, generally routine rhythm, beginning with above the ventricles (SVT begins and ends unexpectedly.)
  • AV nodal reentrant tachycardia (AVNRT)– a quick heart rate due to more than one path through the AV node.
  • Atrial fibrillation– a condition in which lots of impulses start and spread out through the atria, completing for a chance to take a trip through the AV node.
  • Atrial flutter– an arrhythmia brought on by several fast circuits in the atrium.
  • Wolff-Parkinson-White syndrome– a condition where an electrical signal may get to the ventricle too quickly due to an additional conduction pathway or a faster way from the atria to the ventricles.

Ventricular arrhythmias in children consist of:

  • Premature ventricular contractions (PVCs)– early extra beats beginning in the ventricles. These occur when the electrical signal starts in the ventricles, triggering them to contract prior to receiving signals from the atria.
  • Ventricular tachycardia (V-tach)– a deadly condition in which electrical signals start from the ventricles in a fast and irregular rate.
  • Ventricular fibrillation– an irregular, chaotic firing of impulses from the ventricles.


  • Sinus node dysfunction– a slow heart rhythm due to an abnormal SA node.
  • Heart block– a delay or complete block of the electrical impulse from the SA node to the ventricles.

Arrhythmia in Children

How will I understand if my child has an arrhythmia? What are the symptoms?

Recognizing symptoms of an arrhythmia depends upon the age and maturity of your child. Older children can inform you about feeling lightheaded or feeling his or her heart fluttering or “skipping beats.” For infants and toddlers, you might see changes such as paleness of the skin, irritation, and disinterest in consuming. Some common symptoms of arrhythmias consist of:

  • Weakness
  • Exhaustion
  • Palpitations
  • Feeling lightheaded or woozy
  • Fainting or near fainting
  • Paleness
  • Chest pain
  • A slow heartbeat
  • A fast heart beat
  • Feeling pauses in between heartbeats
  • Sweating
  • Shortness of breath
  • Trouble feeding (babies)
  • Irritation in infants

What causes arrhythmias in children?

An arrhythmia can take place as an outcome of internal aspects, such as a disease of the heart muscle itself (cardiomyopathy) or a heart problem the child had when he or she was born (genetic heart disease). Other typical causes of arrhythmia in children include:

  • Infections
  • Chemical imbalances
  • Fever
  • Medications

How are arrhythmias diagnosed?

The doctor will start with a thorough history, consisting of an evaluation of symptoms, and a physical exam. She or he might purchase blood tests to eliminate medications and infections as the cause of the arrhythmia. The doctor may do a test called an electrocardiogram (ECG), which records the heartbeat, to see if it is beating routinely. The doctor may speak with a pediatric cardiologist, a doctor who specializes in children’s heart disorders.

If your child does not have symptoms of arrhythmia at the time of the ECG, the doctor might buy a various type of device to tape your child’s heart beat. These include portable monitors you take home with you that continually record your child’s heartbeat over a duration of days to months. Implantable screens that can be worn for approximately a year or more are likewise readily available.

Other tests that may be required, depending upon your child’s situation, consist of:

  • Electrophysiology tests– During this test, a small, thin tube is inserted into a blood vessel in the leg or arm and advanced to the heart. This enables the doctor to find the site of the arrhythmia’s origin within the heart tissue.
  • Tilt table test– This test is often used in children who have frequent fainting episodes. A tilt table test demonstrates how the heart rate and blood pressure respond to a change in position, resting to standing up.

How are arrhythmias dealt with?

Numerous arrhythmias in children are separated occurrences and safe, and do not require treatment. Oftentimes, arrhythmia is dealt with by treating the underlying issue, such as fever.

Treatment, when needed, depends upon the child’s age and the type and reason for the arrhythmia. Treatment options consist of:

  • Medicine– Many arrhythmias respond to medication and need no other treatment. Nevertheless, medicines have side effects and have to be seen carefully.
  • Radiofrequency ablation– This procedure involves a cardiac catheterization and uses radiofrequency energy applied to the area where the arrhythmia starts, warming it and causing tissue death. This is typically used to treat lots of types of tachycardia.
  • Cardioversion– This is a procedure in which an electrical shock is provided to the heart to transform an irregular or fast heart rhythm to a typical rhythm.
  • Implantable devices:
    • Pacemakers– These are little devices, put just under the skin, that use electrical pulses to control unusual heart rhythm.
    • Implantable cardioverter defibrillator (ICD)– These devices are also positioned under the skin. They use electrical pulses or shocks to assist control dangerous arrhythmias.
  • Surgery– A procedure called Labyrinth surgery can be used to treat atrial fibrillation. During Maze surgery, the cosmetic surgeon makes small cuts or burns in the atria to prevent the spread of messy signals.

When should I take my child to the doctor?

Oftentimes, arrhythmias in children are harmless. However, when arrhythmias take place outside of workout and play, occur typically, or last a very long time– particularly in combination with any of the symptoms listed above– you ought to take your child to a health care specialist.

What is the diagnosis (outlook) for a child with an arrhythmia?

A lot of arrhythmias in children are harmless and do not lead to substantial health issue in the future. Even severe arrhythmias can be successfully dealt with. Depending on any underlying heart disease, the outlook for children with arrhythmias is positive.

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