Management of Heart Rhythm Disorders
Heart rhythm disorders, or arrhythmias, are abnormalities in a heart’s rhythm. In children, they are usually harmless. In some cases, however, they can be serious.
At SSM Health Cardinal Glennon Children’s Hospital, we have pediatric cardiologists who specialize in the care of children diagnosed with arrhythmias, during fetal life and after birth.
What are the signs or symptoms of an arrhythmia in children?
Symptoms vary depending upon the type of heart rhythm disorder. Common symptoms include:
- Heart palpitations
- Shortness of breath
- Chest pain
- Fatigue
- Dizziness
- Fainting
- Difficulty in eating or inconsolable crying, especially in newborns and babies
Our Expertise
If an abnormal heartbeat is detected in a baby prior to birth, we work closely with maternal-fetal medicine specialists and neonatologists, as well as heart specialists and surgeons to provide care as part of our SSM Health Cardinal Glennon St. Louis Fetal Care Institute.
Our Specialized Clinics
We have several specialized clinics that offer comprehensive care for children diagnosed with heart rhythm disorders:
Arrhythmia Clinic
We offer a specialized, weekly Arrhythmia Clinic that enables children to receive comprehensive diagnosis and care for the treatment of a wide range of abnormal heart rhythm conditions that occur in either the upper or lower chambers of the heart, including:
- Atrial flutter
- Supraventricular tachycardia (SVT)
- Wolff-Parkinson-White syndrome
- Premature atrial or ventricular contractions
- Ventricular tachycardia
- Brachycardia
Cardiac Device Clinic
SSM Health cardiologists also have a dedicated Cardiac Device Clinic for patients with implanted pacemakers and defibrillators. This includes care for children as well as adults with repaired congenital heart disease.
Channelopathy Clinic
The Channelopathy Clinic offers management of hereditary disorders of the heart’s conduction system or cardiac channelopathies, including:
- Brugada syndrome
- Long QT syndrome
- Catecholaminergic polymorphic ventricular tachycardia (CPVT)
- Arrhythmogenic cardiomyopathy (ARVC)
- Premature atrial or ventricular contractions
Our specialty clinics are staffed by an electrophysiologist who specializes in cardiac arrhythmia management and a dedicated nurse practitioner. As-needed care is coordinated with cardiovascular surgeons and heart failure specialists.
What to Expect
Children referred to our arrhythmia specialists will undergo a comprehensive evaluation. Children may also be scheduled for an electrocardiogram on their first visit to measure the electrical activity within the heart. As needed, they may also be scheduled for long-term heart rhythm monitoring (Holter monitoring, event monitoring), stress tests, and electrophysiology (EP) studies including cardiac ablations where energy is applied to the heart tissue to treat arrhythmias.
If symptoms don’t occur very often, doctors may suggest implanting a small loop recorder under the skin of the chest area. Like an event recorder, an implantable loop recorder will record electrical activity and any abnormal heart rhythms over a longer time period.
What Are My Child’s Treatment Options?
Certain abnormal heart rhythms do not need treatment; however, in case of arrhythmias that cause serious or ongoing symptoms, your doctor may prescribe medications to control heart rates or to prevent blood clots.
Non-surgical treatment options include learning vagal maneuvers, which are simple physical practices that can calm the heart’s electrical system when it is beating too fast. During a vagal maneuver, your child will learn to:
- Sit or lie down when experiencing a rapid heartbeat
- Slowly take a deep breath and hold it
- Push stomach muscles like you are trying to have a bowel movement
- Exhale after pushing
- Repeat after a minute or two
It’s important to recognize that if the heart continues to beat rapidly despite doing this procedure, you should call your doctor.
Other treatments may require minimally invasive outpatient procedures, such as cardiac catheter ablation procedures for abnormal heart rhythms. For some abnormal heart rhythms, our specialists will perform a procedure to implant a heart device, such as a pacemaker or cardioverter-defibrillator (ICD). In almost all cases, children are back to their typical activities within a few days of a procedure.
Remote Monitoring Program
SSM Health Cardinal Glennon offers remote monitoring for children with pacemakers and ICDs. The program allows patient to securely send information from their devices directly to their doctor without coming to the hospital every month for evaluation.
