Treating Arrhythmias in Children
If your child has been diagnosed with arrhythmia, an abnormal heart rhythm, you’re likely concerned. That’s understandable.
Learning about arrhythmias can help you understand what your child’s doctor has told you. It’s the first step in caring for your child, as you work with your pediatrician to determine the best treatment option.
Normal ranges for children
A child’s heart usually pumps blood in a synchronized, uniformed way, at regular intervals.
For children as well as for adults, the heart rate, or number of times a heart beats each minute, can vary. Exercise, for example, makes the heart beat more often, while the heart rate slows down during sleep.
The normal resting heart rate for an older child or teenager at rest is 60 to 100 beats per minute. In an infant, the heart beats 100 to 190 times a minute on average.
Some arrhythmias are normal. In many children, the heart rate speeds up while breathing in, then slows back down when exhaling. This heartbeat variation with breathing is called sinus arrhythmia, and it’s no cause for concern.
If your child's doctor discovers an arrhythmia, they will likely perform tests to learn more. You could also be referred to a pediatric cardiologist, who specializes in heart issues in children.
View an animation of an arrhythmia.
Arrhythmias and medical history
Arrhythmias may occur at any age, although the condition is more common in adults.
Children with arrhythmias often experience no symptoms, or they can’t articulate the problem. These abnormal heart rhythms may be revealed as part of a child’s periodic wellness exam or other visit with your child’s health care professional.
Arrhythmias are investigated much like other health conditions. Your child's pediatrician will likely inquire about your child’s medical history to understand everything possible about the arrhythmia, its origins and implications.
You may be asked questions such as:
- Is your child aware of unusual heartbeats?
- How long has this been happening?
- Does anything bring on the arrhythmia?
- Is there anything your child or you can do to make it stop?
- How fast is your child’s heartbeat?
- Does your child feel weak, lightheaded or dizzy?
- Has your child ever fainted?
Your child’s doctor may also ask about prescribed and over-the-counter medicines because some may make arrhythmias worse.
By knowing all that you can about arrhythmias, you can take an active role in your child’s care. Together, you and your child’s doctor can determine the best treatment option.
Many options are available to treat rhythm abnormalities in children. Most treatment is directed at a specific problem.
Medications
Many rhythm disorders, especially tachycardias, respond to medications. These drugs can't cure the arrhythmia, but they can improve symptoms. They do this by preventing the episodes from starting, decreasing the heart rate during the episode or shortening how long the episode lasts.
Several medications may need to be tried before the right one is found. How much and how often a medication should be taken will depend on many factors. It's very important to take the medication as prescribed.
All medications have side effects, including drugs to treat arrhythmias. Most of the side effects aren't serious and disappear when the dose is changed or the medication is stopped. But some side effects are very serious. That's why some children are admitted to the hospital to begin the medication. If your child is prescribed medication, it's very important that your child take the medication just the way the doctor prescribes it.
It's often necessary to monitor how much of a drug is in your child's blood. The goal is to make sure there's enough of the drug to be effective, but not so much that harmful side effects occur. These blood tests require taking a small amount of blood from a vein or the finger. It's a good idea to talk to your child about this before seeing your child's health care professional.
Other treatments
Radiofrequency ablation
Radiofrequency catheter ablation destroys the tissue causing the abnormal electrical signals using a special catheters in the heart. One is positioned right over the area that's causing the tachycardia. Then its tip is heated, and that small area of the heart is altered so electrical current won't pass through the tissue.
Surgery
Sometimes, surgery that interrupts the abnormal connection in the heart is required to permanently stop the tachycardia.
Pacemaker
A variety of rhythm disorders can be controlled with a pacemaker. Slow heart rates, such as heart block, are the most common reason to use a pacemaker. But new technology now lets health care professionals treat some fast heart rates with a pacemaker too. A pacemaker is a small device (1 to 2 ounces, 1.5 by 1.5 inches). It's put inside the body and connected to the heart with a thin wire. It works by sending small, painless amounts of electricity to the heart to make it beat.
Inserting a pacemaker is a well-established operation. The wires are attached to the heart, and the pacemaker is placed in the abdomen (belly) or under the skin of the chest wall. Sometimes only one wire is attached to the heart. In other cases, two wires are used. Many different models and brands of pacemakers exist. Some can sense when your child is active and increase the heart's beating to keep up with exercise.
If your child has a pacemaker, they will need regular checkups. It's important to check the pacemaker's battery and make sure the wires are working properly. Pacemaker batteries usually last for years, but the pacemaker will still need to be replaced periodically throughout the user's lifetime. Sometimes the wires also need to be replaced. Regular checkups can show if anything needs replacing.
Most children with pacemakers can engage in normal activities but may be advised against participating in some contact sports. Talk to your child's cardiologist about this.
