Cardiac Arrhythmias

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. Even once children are old enough to know something doesn’t feel “right”, the abnormal heartbeat might only happen at certain times, making it difficult to identify.

Tachycardia is a heartbeat that is faster than the body requires. The most common is supraventricular tachycardia (SVT). There are also ventricular tachycardias, including ones we see in our Cardiovascular Genetics Clinic, such as Long QT Syndrome (LQTS) and CPVT.

Symptoms of tachycardia may include:

  • 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)

Bradycardia is when the heart beats too slow. The most common is heart block.

With bradycardia, we tend to see symptoms such as:

  • Trouble feeding (in infants)
  • Fatigue and lack of energy
  • Tiring easily during physical activity
  • Dizziness
  • Fainting

When to See a Doctor 

If you feel your child’s heart is beating too fast, too slowly or is skipping a beat, request an appointment to see a doctor.

Seek immediate medical attention if your child is experiencing shortness of breath, extreme weakness, dizziness, lightheadedness, fainting or near fainting episodes.

How Do We Treat Arrhythmias in Children?

Many children come to an electrophysiologist and we discover that they do not have a heart rhythm problem. These children do not need heart rhythm treatment and do not need to see an electrophysiologist in the future.

In children who do have a heart rhythm problem, the right treatment depends on the child’s age, the presence of other health conditions, family and patient goals, and the severity of the symptoms and diagnosis. Some children do not need treatment right away and be monitored over time. In those patients where treatment is needed, electrophysiologists often prescribe one of these approaches:

  • Medication. Medication therapy can be an effective way to suppress arrhythmias and eliminate symptoms.
  • Ablation. This procedure is performed using a catheter to alter abnormal tissues that can cause arrhythmias.
  • Pacemaker. A pacemaker is a heart rhythm device that treats some causes of abnormally slow heart rates (or bradycardia). This device provides an external source of electricity to the heart to keep it in a steady, safe rhythm.
  • Implantable cardioverter defibrillator (ICD). An ICD is a device that can detect abnormal and dangerous heart rhythms. It can send electrical signals or even shocks to stop life-threatening fast heart rhythms (or tachycardia). Some ICDs can also work as pacemakers.
  • Genetic testing. Some arrhythmias are caused by abnormalities in the genetic code. Our team is expert in diagnosing these conditions, determining the genetic abnormality or abnormalities, and using that information to optimize treatment for the patient and counsel family members who may be at risk for inherited heart rhythm disease. In many cases, patients and families come to use because they discover that a family member has an inherited heart rhythm disease or because a screening test showed a risk of an inherited heart rhythm disease. Our team will work with you to provide an expert assessment of risk and to treat the problem, if needed.

Learn more about treatment options available with our EP Program

Long-Term Effects of Pediatric Arrhythmias

Arrhythmias are most dangerous when they go undiagnosed. Proper diagnosis allows for appropriate management for a child’s arrhythmia.

Most heart rhythm problems are not life-threatening. At Lurie Children’s, we seek to prevent symptoms of heart failure or dangerous episodes of sudden cardiac arrest, while allowing kids to be kids. We work closely with families to help them make the best decisions for and with their child. Many families come to us because another physician has asked their child to stop playing sports until a heart rhythm evaluation can be completed. We recognize how important sports are to children and families and our goal is to help most kids return as quickly as possible to sports and full participation.

In addition, we can 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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