An arrhythmia is an abnormal rhythm of the heart. It can either be too fast, too slow or not regular. With an arrhythmia, the heart may not be able to pump enough blood to the body with each beat. Some arrhythmias may be benign, while others can be life-threatening.

Atrial Arrythmias

Sinus Arrhythmia 
A condition in which the heart rate varies with breathing. This is usually a harmless condition with no symptoms.

Sinus Tachycardia
A condition in which the heart rate is faster than normal for the child's age. This is caused when the heart’s natural pacemaker (the sinus node) is sending out electrical impulses at a rate faster than usual. It may cause symptoms such as weakness, fatigue or dizziness. It may cause symptoms of heart racing. This is often a normal response to stress from exercise, strong emotions, fever or dehydration. Sinus tachycardia normally goes away on its own.

Sick Sinus Syndrome 
The heart’s natural pacemaker (the sinus node) sends out electrical signals either too slowly or may even pause briefly. 

Atrial Flutter
The heart’s electric system causes the two upper heart chambers (atria) to beat too fast. The heart rate is fast but even.

Atrial Fibrillation 
The heart’s electric system causes the two upper heart chambers (atria) to beat too fast and not evenly.

Premature Supraventricular Contractions or Premature Atrial Contractions (PAC) 
One of the heart’s pacemakers in one of the two upper chambers (atria) sends an electrical signal too early. This causes an extra or a missed heartbeat and an uneven rhythm.

Supraventricular Tachycardia (SVT), Paroxysmal Atrial Tachycardia (PAT)
One of the heart’s pacemakers sends a series of electrical signals too early. They usually start and end quickly. This condition can cause weakness, fatigue, dizziness, fainting or palpitations if the heart rate becomes too fast.

Ventricular Arrythmias

Premature Ventricular Contractions (PVCs) 
One of the heart’s pacemakers in one of the two lower chambers (ventricle) sends an electrical signal too early. This causes an extra or a missed heartbeat and an uneven rhythm. PVCs are common and often do not cause problems. However, if the frequency of the PVCs increases to several per minute, your child may experience weakness, fatigue, dizziness, fainting or palpitations.

Ventricular Tachycardia (VT)
An electrical signal is sent from one of the two lower chambers (ventricle) at a very fast but even rate. If this goes on for a long time, there can be symptoms such as weakness, fatigue, dizziness, fainting or palpitations.

Ventricular Fibrillation
An electrical signal is sent from one of the two lower chambers (ventricle) at a very fast but uneven rate. The ventricles don’t fill with blood and pump it out. This causes a very low blood pressure. It can also lead to weakness, dizziness, fainting or loss of consciousness.

The symptoms of various arrhythmias may resemble other medical conditions or heart problems. Always consult your child's physician for a diagnosis.

Inherited Arrhythmia Disorders
Some arrhythmias are genetic and may be passed down through different family members. If a parent has an inherited arrhythmia, then they often have a 50% chance of passing that disease on to their child. Examples of these diseases would include:

• Long QT syndrome
• Catecholaminergic polymorphic ventricular tachycardia (CPVT)
• Brugada syndrome

Our team helps patients and their families diagnose these diseases in different family members, and can provide the needed treatment to reduce their risk of experiencing a lift-threatening arrhythmia.

Specific treatment for arrhythmias will be determined by your child's physician based on:

• Your child's age, overall health and medical history
• Extent of the condition
• Your child's tolerance for specific medications, procedures or therapies
• Expectations for the course of the condition
• Your opinion or preference

Arrhythmias may cause few, if any, problems. In this case, your child may not need treatment. However, when the arrhythmia causes symptoms, there are several different options for treatment.

Many arrhythmias can be treated with lifestyle changes and medications. Other potential treatments include:

Cardioversion
In this procedure, a small, electrical shock is delivered to the heart through the chest. This can stop very fast arrhythmias, such as atrial fibrillation, supraventricular tachycardia or ventricular tachycardia.

Ablation
This is an invasive procedure done in the electrophysiology laboratory. It involves putting a small, thin tube (catheter) into the heart through a vessel in the groin and occasionally through the neck. Once the site of the arrhythmia is identified, it is destroyed either with high heat (radiofrequency ablation) or extreme cold (cryoablation) delivered through a catheter.

Pacemaker
A permanent pacemaker is a small device that is placed under the skin and sends electrical signals to start or regulate a slow heart beat. A permanent pacemaker may be used to make the heart beat if the its natural pacemaker (the sinus node) is not working. Pacemakers are typically used for slow arrhythmias such as sinus bradycardia, sick sinus syndrome or heart block.

Implantable Cardioverter Defibrillator (ICD)
A small device, similar to a pacemaker, is placed under the skin. When the heart beats too fast or develops a life-threatening arrhythmia, the ICD sends a small electrical shock to the heart to slow it down. ICDs are typically used for fast arrhythmias such as ventricular tachycardia.

Surgery
Surgeries for arrhythmias is usually done only when all other options haven’t worked. During surgical ablation, the chest is opened. The site of the arrhythmia is located and then destroyed or removed.

For some families, it can be helpful to come prepared with a plan before your appointment with a cardiologist. Here are things to consider documenting and having ready for your appointment:

• Symptoms your child is experiencing: Sharing when these symptoms appeared and how frequently they occur is helpful to the medical team. Don’t be afraid to share symptoms that seem unrelated — congenital heart disease can affect other parts of the body.
• Medications: This should also include any supplements or vitamins your child takes.
• Related history: This includes family medical history and recent changes in your family’s life.
• Your questions: This will help ensure you don’t forget to ask all your questions. It is okay to ask the same question several times if you are unclear. Our team is here to help you understand the big picture and make sure you walk away with your questions answered.