Arrhythmia

Overview

What is arrhythmia?

An arrhythmia is an abnormal heartbeat (too fast, too slow, or irregular) that can cause the heart to pump less blood to the body than it should. Sometimes arrhythmias are harmless. Other times, an arrhythmia is dangerous and can do damage to the heart muscle and the entire body.

In the normal heart, a group of nerves in the upper right heart chamber (right atrium) sends small electrical shocks to the heart muscles that make them contract and expand in a regular, rhythmic fashion. This creates a heartbeat and ensures that the heart is pumping adequate amounts of blood to the body (known as normal cardiac output).

But in some cases, the nerve group doesn’t send the correct electrical pulses. In other cases those electrical pulses don’t travel through the heart appropriately, or they go too fast or too slow. This creates an arrhythmia.

What types of arrhythmia do we treat?

The most common types of arrhythmia we treat at the Children’s Hospital Colorado Arrhythmia Center include:

• Supraventricular tachycardia (SVT): This condition causes the heart to speed up inappropriately. The rapid heartbeat is usually well-tolerated and stops on its own after about an hour. Other times, the rapid heartbeat does not slow down and causes fainting or lightheadedness, and emergency treatment (911) is necessary.

• Ventricular tachycardia (VT): In this condition, the heart’s electrical impulses originate in the bottom chambers (ventricles) instead of the atria. The impulses are also too fast (like SVT) and are often much more dangerous than SVT.

• Atrial flutter: In this condition, electrical impulses come from the top of the heart chambers (atria) too quickly. An atrial flutter is usually seen in children following cardiac surgery.

Programs & Treatments

How can heart arrhythmia be treated?

There are many treatment options for heart arrhythmias. These options will depend on your child’s health, the type of arrhythmia he or she has, and the severity of the arrhythmia.

At the Heart Institute, your child’s pediatric cardiologist will work with the arrhythmia team to develop the treatment plan that’s best for your child. Common treatments for arrhythmia are:

• Lifestyle changes: Stress and caffeine can trigger arrhythmias or make them worse. Your cardiologist may recommend that your child avoid these or other lifestyle factors.

• Medication: There are many medications that help regulate heartbeats (known as antiarrhythmics). These medications are specific to slow heartbeats (bradycardia) or fast heartbeats (tachycardia). The medications your pediatric cardiologist prescribes will depend on what other medications your child may be taking.

• Cardiac catheterization: Catheter ablation is one treatment specialists at the Heart Institute use to correct an arrhythmia. In this minimally invasive, transcatheter procedure, doctors insert a catheter through the leg veins and into heart chambers to burn (radiofrequency) or freeze (cryoenergy) and eliminate the sources of heart irregularities. More than 90% of the time, this permanently cures the arrhythmia and no further treatment or activity limitations are necessary.

• Medical implants: Cardiologists at the Heart Institute may suggest implanting a medical device that controls the electrical impulses of your child’s heart. A pacemaker and implanted defibrillator are two types of implanted medical devices used for arrhythmia.

• Heart surgery: Surgery is an option for children with severe arrhythmias that have not responded to other treatments. A cardiothoracic surgeon will examine the heart and remove the tissue that is creating the abnormal electrical activity.

Learn more about our Arrhythmia Center.

Living with arrhythmia

With regular follow-up care, children with controlled arrhythmia can lead normal, healthy lives. Talk to your child’s cardiologist about the signs and symptoms of arrhythmia so you’re able to recognize any changes or potential problems with your child’s condition.

Signs & Symptoms

What are the signs and symptoms of arrhythmia?

Common symptoms can include:

• Heart palpitations
• Fluttery feeling in the chest
• Chest pain
• Dizziness
• Fainting
• Trouble exercising
• Extreme fatigue

Children with arrhythmia also often have a family history of abnormal heart rhythms. If your child has experienced some of the above symptoms, please contact your doctor.

Note that in many cases, a child has no obvious symptoms. Pediatricians sometimes first notice the condition while listening to a child’s heart during a physical exam.

Diagnosis & Tests

How is arrhythmia diagnosed?

After hearing an irregular heartbeat during a physical exam or obtaining a medical history with its symptoms, your doctor will refer your child to a pediatric cardiologist at Children’s Hospital Colorado for testing.

We provide several types of non-invasive and pain-free tests for arrhythmias, which can include:

• Electrocardiograms (EKG)
• Holter monitor (for 24-hour monitoring at home)
• Transient arrhythmia monitoring

Other types of testing include:

• Exercise testing
• Tilt Table testing
• Drug testing
• Electrophysiology (EP) studies

Helpful resources:

To learn more about arrhythmia and children, visit:

• The American Heart Association
• Children’s Hospital Colorado Health Library
• Heart Rhythm Society
• Pediatric and Congenital Electrophysiology Society (PACES)