Arrhythmias in Children

Sometimes an abnormal heartbeat is temporary and harmless, perhaps a result of an illness. Some medications can also cause arrhythmias. Children with congenital heart disease may develop arrhythmias depending on the nature of their heart abnormality and treatments they’ve received for it.

While some arrhythmias go away over time, others may need treatment. We’ve seen it all, and we’re prepared to learn more about your child’s unique situation and recommend the best path forward.

Types of arrhythmias in children

There are many types of arrhythmias in children, ranging from harmless to serious. Some cause no symptoms, while others cause heart palpitations. Less often, children may feel dizzy or lightheaded, faint, have chest pain or feel short of breath. Infants and toddlers may look pale and seem fussy, uninterested in eating or breathe rapidly. What your child feels and what you notice can vary based on the type of arrhythmia.

The most common arrhythmia that affects children is supraventricular tachycardia (SVT). This abnormal heartbeat begins in the top chambers of your child’s heart (atria). There are many specific types of SVT, including:

• AV nodal reentrant tachycardia (AVNRT).
• Wolff-Parkinson-White syndrome (WPW).
• Atrial tachycardia.
• Atrial flutter.
• Atrial fibrillation (Afib).

Other arrhythmias that can affect children include:

• Premature atrial contractions (PACs).
• Premature ventricular contractions (PVCs).
• Sick sinus syndrome.
• Heart block.
• Ventricular tachycardia (V-tach).
• Ventricular fibrillation (V-fib).

What to expect at your first visit

We’re here for you and your child beginning with our first conversation. We’ll start by getting to know you and learning about your child’s symptoms. We understand you may feel nervous, and we’ll do everything we can to help you and your child feel comfortable.

We’ll spend some time talking about any symptoms your child feels, or you notice. We’ll go over your child’s medical history and their family history. It helps to know if any biological family members had arrhythmias or other heart conditions. Some types of arrhythmias can run in families.

To learn more, we’ll do a physical exam and tests, like:

• Blood tests to rule out medications or infections as the cause of an arrhythmia.
• Electrocardiogram (EKG) to record your child’s heartbeat and see if it’s regular or irregular.
• Ambulatory monitors, like holters or cardiac event monitors to record your child’s rhythm over extended periods of time or to capture events that are less frequent.
• Exercise stress test to check for abnormal heart beats with activity.
• Echocardiogram (Echo) to find underlying heart conditions that may put your child at risk for arrhythmias.
• Electrophysiology tests to find exactly where an arrhythmia is starting in your child’s heart.
• Implantable loop recorders to record your child’s heart rhythm over three years.

If your child doesn’t have symptoms when they have their EKG, we may give you a portable monitor to use at home. It’ll record your child’s heartbeat over a period of days to weeks. We’ll explain exactly how it works and what to do with it. 

If we diagnose your child with an arrhythmia, we’ll talk about what that diagnosis means and whether your child needs treatment. We’ll also let you know if they need to limit exercise or other activities. Don’t hesitate to share your questions or concerns with us at any point in this process. We know it’s important to share information with you, but we also know it’s equally important to listen.

Meet Our Pediatric Arrhythmia Team

Teamwork drives all that we do at Cleveland Clinic Children's. You can expect to work with a dedicated team of pediatric healthcare providers, like:

• Pediatric cardiologists, including those trained in congenital (born with it) heart disease and electrophysiology.
• Pediatric nurses.
• Pediatric nurse practitioners.
• Genetic counselors.

Your child may not need any treatment. But if they do, we’ll provide the latest treatments based on their needs. Options include:

• Medications: Many times, medications are enough to help your child’s heart beat in a normal rhythm.
• Implanted cardiac devices: Your child may benefit from a device like a pacemaker to help their heart beat normally or an implantable cardioverter defibrillator (ICD), which intervenes to treat dangerous ventricular arrhythmias.
• Procedures: Your child might need a minimally invasive procedure called cardioversion or catheter ablation to treat an abnormal heartbeat or abnormal rhythms.

Follow-Up Care

We may need to see your child on a regular basis to check up on their heart. We’ll talk with you about any follow-ups your child needs and why they’re important. We’ll also help you and your child manage any lifestyle changes that can help protect their heart, like avoiding certain types of exercise.

Taking the Next Step

As a parent, you want to be able to tell your child everything will be OK. It can be hard to do that when you don’t know exactly what’s wrong. In moments like these, having a healthcare team you trust makes all the difference. We’ll find out what’s going on and what we can do to make things better. Whether the arrhythmia is a harmless, temporary nuisance or a sign of a condition that needs treatment, we’ll be here for you and your family every step of the way.