Arrhythmias in Children

Arrhythmias in Children

Irregular Heartbeat, Heart Rhythm Disorders

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You want your child’s heart to beat strong and steady, from infancy throughout their lifetime. When you seek treatment for your child’s arrhythmia at Duke Children’s, that’s our goal, too.

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Understanding Arrhythmias in Children

What is an Arrhythmia?
A child's normal heartbeat changes with age. However, when a child’s heart beats too fast, too slow, or irregularly, it’s called an arrhythmia. An arrhythmia could indicate that there is a problem with the body’s electrical signals that tell the heart muscle when and how to beat.

Why do Arrhythmias Occur?
Arrhythmias can occur in children before birth, but most develop after birth. They can occur in infants, young children, or teenagers. There are many causes of arrhythmias, including imbalances of electrolytes in the blood, certain medications, abnormal electrical pathways in the heart muscle, congenital heart defects, a heart muscle disease called cardiomyopathy, or genetic heart cell problems that can occur in families (such as Long QT Syndrome). Arrhythmias may also occur following heart surgery.

When to See a Pediatric Cardiologist 
Arrhythmias can be harmless -- or they can cause dizziness, fainting, or even sudden cardiac death. If your child has an abnormal heartbeat, it’s important to have it checked by a pediatric cardiologist. Your child may be seen by a pediatric electrophysiologist, who specializes in heart rhythm disorders in children.

Our Locations
Duke Health offers locations throughout the Triangle. Find one near you.

Diagnosing and Treating Your Child’s Arrhythmia

Our pediatric cardiologists evaluate your child's symptoms, which may include:

  • Fainting
  • Palpitations
  • Irregular heart rhythms
  • History of sudden cardiac arrest

If your child has had fainting episodes, it may be a sign of a heart rhythm issue, or it could have another cause -- for example, a problem with the autonomic nervous system (the part of the nervous system that controls “automatic” body functions, such as heartbeat and breathing). 

Your Child's Heart Care Team
If your child is diagnosed with an arrhythmia, you can rely on Duke Children’s for comprehensive, expert heart care. Our team will thoroughly evaluate your child to determine the cause of their fainting and recommend the most appropriate treatment. Your child's team may include:

  • A pediatric electrophysiologist who has completed additional training in diagnosing and treating heart rhythm disorders in children. All of our pediatric electrophysiologists have years of experience performing advanced procedures to treat problems with electrical signals in the heart.
  • A dedicated pediatric procedure team -- including anesthesiologists and nurse anesthetists -- all of whom are certified specialists with specific training in providing care for children’s hearts.
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Electrophysiology (EP) Study

While your child is sedated or under anesthesia, the doctor inserts a catheter (a narrow tube) into a vein or artery and directs it toward the heart. Using electrodes attached to the catheter, the doctor can test the heart’s electrical signals, to help identify what’s causing abnormal heart rhythms and what types of treatment might be most effective.

Radiofrequency Ablation

During an EP study, or in a separate catheterization procedure, the electrophysiologist may use a special catheter that sends radiofrequency (RF) energy to heat and destroy abnormal heart tissue that is causing irregular heart rhythms.


Similar to radiofrequency ablation, except the electrophysiologist employs a catheter that uses extreme cold to destroy the abnormal heart tissue.

Pacemaker and Defibrillator Implantation

A pacemaker uses electrical impulses to help control the speed and rhythm of your child’s heart. An implantable cardioverter defibrillator (ICD) monitors your child’s heartbeat and can deliver an electric shock to “reset” the heart when it detects a dangerous heart rhythm. Most ICDs also function as pacemakers. Either device can usually be implanted in an outpatient procedure.

Laser Lead Extraction

Duke is a leader in providing laser lead extraction. If pacemaker or defibrillator wires placed inside the heart become damaged or blocked due to scar tissue or infection, our doctors can remove them through a small incision during this operating-room procedure.

Advanced Pediatric Arrhythmia Care

At Duke Children’s, your child will benefit from the most advanced treatments available, delivered in a compassionate and family-focused environment.

Dedicated Pediatric Cardiac Catheterization and Electrophysiology Labs
Our two fully-equipped pediatric cardiac catheterization and electrophysiology labs have the latest 3-D mapping systems, allowing the greatest precision for procedures on the smallest, most delicate hearts.

Minimized Radiation Exposure
We perform procedures with the lowest possible radiation dose to minimize any future health risks to your child.

Remote Monitoring
If your child has a pacemaker or defibrillator, we can keep track of their heart rhythms between visits with remote monitoring, saving you travel time. A monitoring station in your home sends data from your child’s device to their care team. They evaluate it and determine whether a clinic visit is needed.

Fetal Cardiology Specialists
If your child’s heart problem is diagnosed before birth, our fetal cardiology team ensures your child gets appropriate care -- including having a pacemaker implanted, if needed -- as soon as possible after delivery.

Coordinated Family Care for Genetic Heart Diseases
If someone in your family has been diagnosed with a genetic disease that causes arrhythmia, we partner with our colleagues in adult electrophysiology to evaluate family members who may have inherited the condition and help coordinate care for the entire family.

Best Children's Hospital in NC
In addition to being among the best in the country, Duke Children's Hospital & Health Center is proud to be nationally ranked in nine pediatric specialties.
Reviewed: 06/19/2018