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 abnormal heart rhythms can help you understand what your child’s health care professional has told you. It’s the first step in caring for your child as you work with your pediatrician to decide 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 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 abnormal heart rhythms 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 health care professional discovers an abnormal heart rhythm, they will likely perform tests to learn more. You could also be referred to a pediatric cardiologist, who specializes in heart issues in children.
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Arrhythmias and medical history
Arrhythmias may occur at any age, although the condition is more common in adults.
Children with arrhythmias often have 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 visits 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 abnormal heart rhythm, 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 health care professional may also ask about prescribed and over-the-counter medicines because some may make arrhythmias worse.
By knowing all you can about arrhythmias, you can take an active role in your child’s care. You and your child’s health care professional can decide the best treatment option.
Many options are available to treat rhythm abnormalities in children. Most treatment is directed at a specific problem.
Medications
Many heart rhythm disorders, especially tachycardias, respond to medications. These drugs can't cure the arrhythmia, but they can improve symptoms. They prevent 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 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 severe. 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 takes it exactly as the health care professional prescribes it.
It’s often necessary to monitor how much of a medication is in your child’s blood. The goal is to make sure there’s enough of the medication 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 good 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 abnormal electrical signals using 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 currents won’t pass through the tissue.
Surgery
Sometimes, surgery that interrupts the abnormal connection in the heart is required to stop tachycardia permanently.
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 newer technology 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 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 your child’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 heart doctor about this.
