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Pediatric Arrhythmias & Electrophysiology

Arrhythmia is an abnormal rhythm of the heart. It means that a child’s heart is beating either too fast or too slow.

Just as electricity flows through power lines, electrical signals flow through the heart. When signals and pathways don’t work as they should in this electrical flow, it creates an arrhythmia. These electrical problems usually happen because of a condition a baby is born with or an illness that affects the heart.

Doctors who study and treat arrhythmias are called electrophysiologists (EPs). At Lurie Children’s, we have a large EP program that diagnoses and treats all types of arrhythmias in children and adolescents.

What Are the Types of Pediatric Arrhythmias?

“Arrhythmia” is a big term that refers to many different problems with the heart’s electrical system. Abnormal heartbeats range in symptoms, causes and severity. Some arrhythmias happen at rest, whereas others may only emerge during exercise.

EPs generally divide arrhythmias into these two groups:

What Are Symptoms of Arrhythmia in Children?

Babies can’t tell you their heart is beating too fast or too slowly. And even once children are old enough to know that something doesn’t feel right, the abnormal heartbeat might only happen at certain times. This is why symptoms can be tricky to spot.

There are some symptoms we look for, though. For tachycardia, this includes:

  • Heart palpitations either at rest or during exercise (these do not always mean something is wrong)
  • Chest pain (children with a racing heart may label this as pain)
  • Dizziness
  • Shortness of breath
  • Fainting (called syncope)

With bradycardia, we tend to see symptoms such as:

  • Trouble feeding (in infants)
  • Fatigue and lack of energy
  • Getting tired out very easily during physical activity
  • Dizziness
  • Fainting

How We Diagnose &Treat Arrhythmia

We are often able to diagnose an arrhythmia before a baby is born, through our Fetal Cardiology Program. If your obstetrician hears something that doesn’t sound right, they may send you for a fetal echocardiogram to look more closely at your baby’s heart.

We also use a simple, noninvasive procedure called an electrocardiogram, or EKG, to gather electrical information about the heart. We can perform EKGs on children of any age.

Not all arrhythmias show up on an EKG. We often have children wear a Holter monitor, so we can look at their heartbeats over 24 hours. Our team is very good at reading these, and picking up abnormalities others may miss.

If the abnormal rhythm is dangerous or is causing symptoms that interfere with life, then we look at treatments.

For tachycardia, we may start with medication. For some children, we’ll do cardiac ablation which gets rid of the arrhythmia for good. For some types of tachycardias, we’ll recommend implanting a device that can shock the heart back to a normal rhythm.

There are some medications we use for bradycardia, but if the arrhythmia is severe enough, we look at other options. Usually, a child will need a permanent pacemaker. We’re experts at implanting these.

Why Choose Lurie Children’s for Electrophysiology?

Our EP Program sees a large volume of children, from Chicago and beyond. Parents feel confident in coming here because:

  • We have leading heart care: U.S. News & World Report ranks us among the top hospitals for pediatric cardiology and heart surgery. This means we are able to treat children with even the most complex heart rhythm issues.
  • Our team is integrated into every part of the Heart Center: We have a large team of EP specialists who are on call 24/7 and manage children with all types of arrhythmias. We have our own clinic and outreach programs for parents.
  • We use the latest ablation technology: The standard is radiofrequency ablation, which uses heat to burn tissue causing the arrhythmia. But we’re one of the few programs in the region to also offer cryoablation therapy. This uses cold to freeze the tissue and is safer for some types of arrhythmias.
  • Our complication rate is exceedingly low: We are lower than the national average for complications during arrhythmia-related procedures.

Long-Term Effects of Pediatric Arrhythmias

Arrhythmias are most dangerous when they are undiagnosed. Once we have a diagnosis, we can manage a child’s arrhythmia.

We seek to prevent symptoms of heart failure or dangerous episodes of sudden cardiac arrest. We also want kids to be able to be kids. We work closely with families to help them make the best decisions for their child.

We continue to monitor children with arrhythmias as they become adults, through our Adult Congenital Heart Disease (ACHD) Program.

Heart Center Family Resource Guide

To help prepare families for their care with Lurie Children's Heart Center, we have compiled a list of resources about treatment and recovery. Learn how to get ready for an inpatient stay or outpatient visit, and read about our support services for patients and families.

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