Arrhythmias in Children

An arrhythmia is an abnormal heart rhythm, or a change from the heart's regular electrical impulse. Arrhythmias can cause the heart to beat too quickly (tachycardia), too slowly (bradycardia) or irregularly. As a result, the heart may not effectively pump blood to vital organs. Cardiologists at Comer Children's Hospital are experts in diagnosing and treating heart rhythm disorders in children of all ages. As part of our comprehensive approach, we work with each family to help them understand the signs and symptoms of arrhythmias and to determine the best treatment for their child.

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Signs & Symptoms

Signs and symptoms of arrhythmias in young children include irritability or lack of interest in eating. Older children and teenagers may complain of abnormal beating of their heart (know as palpitations), or feeling tired, weak, or lightheaded. Other signs and symptoms include:

Fatigue
Dizziness
Fainting
Heart palpitations
Poor feeding (in infants)

Congenital heart disease or other cardiac disorders may cause arrhythmias. Heart rhythm disorders may also occur when a child has a fever, or as a result of certain medications.

Diagnosing Childhood Heart Rhythm Disorders

Our physicians will start by taking a medical history and performing a physical exam. We may also some of the following tests:

Electrocardiogram: Electrocardiogram (EKG), which uses electrodes to measure the electrical activity of the heart.
Holter Monitor: Holter monitor or event recorder, which allows longer periods of heart rhythm monitoring, without keeping a child in the hospital or disturbing their usual activities.
Electrophysiology Study (EPS): Electrophysiology study (EPS), in which a catheter (small, flexible tube) is inserted into a blood vessel to determine the origin of an arrhythmia.
Tilt Table Test: Tilt table test, which shows how a patient's heart rate and blood pressure respond to a change in position (e.g. lying down versus standing up). This test often is used for children with syncope, or frequent fainting.

Treating Arrhythmias in Children

Many types of arrhythmias in children are temporary and do not require treatment. In some cases, however, treatment is required. Options include:

Medication

Medication often is the first step. Medications are non-invasive treatments and can be tailored to patients to avoid side effects. Medications can control abnormal heart rhythms and, in many cases, allow the body to slowly fix the cause of the abnormal heart rhythm over time. However, in other cases, stopping the medication will allow the heart rhythm problems to return. In these cases, the use of medication as a treatment would mean life-long medications.

Ablation

Ablation therapy can be a permanent fix of an abnormal heart rhythm that can give most patients a lifetime without heart rhythm medications. An ablation is when the abnormal cells in the heart that are causing the arrhythmia are identified and energy is delivered to these cells to stop their ability to cause these abnormal heart rhythms. This procedure is done through a cardiac catheterization, without opening a child’s chest. It typically allows patients to go home the same day, or the morning after their procedure. However, since it is an invasive procedure, very small children may not be candidates for ablation therapy.

Pacemakers & Defibrillators

Pacemakers are small implantable machines that help regulate a child's heart rhythm. Pacemakers work by monitoring the heart rhythm to detect when the heart “skips” beats, and can give its own signal for the heart to beat. Defibrillators are similar to pacemakers, but they detect when the heart is having a life-threatening arrhythmia and deliver a “shock” to the heart to stop the abnormal rhythm. Your child's physician will discuss options based on the severity of the condition, your child's age, health history and other factors.

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Pediatric patient Drew Mastrino and his mom, Kristina Mastrino of Naperville, Il, on January 16, 2013. Drew is treated at Comer Children's Hospital by pediatric gastroenterologist TImothy Sentongo, MD, for an allergic condition called eosinophilic esophagitis (EoE).

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