Like every muscle in your body, your heart depends on electrical signals to coordinate contractions between the four chambers of heart to move blood effectively through the heart to the lungs to be oxygenated and back to the body. A cardiac arrhythmia happens when a problem occurs in the heart’s electrical conduction system. The chambers may become uncoordinated and the heart may beat too fast, too slow or develop an irregular beat that affects how blood is pumped and enough oxygenated blood may not be delivered to the body. Whether your child’s arrhythmia is harmless or requires treatment, a pediatric cardiologist can provide the best recommendation for your child’s health.

Wellness & Prevention

Dozens of times each minute, your heart’s electrical system sends split-second signals throughout the four chambers to coordinate contractions, move blood through the chambers and lungs and complete a single heartbeat. After each beat the chambers relax to fill with blood and the electrical system starts another cycle.

A cardiac arrhythmia, or an abnormal pattern of electrical activity, may happen if the heart’s natural pacemaker develops an unusual rate or rhythm, a congenital heart defect is present, the heart muscle is damaged, another part of the heart becomes the pacemaker or a normal electrical pathway is interrupted.

Other causes include high blood pressure, an overactive or underactive thyroid, stress, diabetes, sleep apnea, blocked arteries in the heart and taking certain medications or supplements. In adults, smoking, drinking too much alcohol or caffeine and drug abuse can also contribute.

Children with cardiac arrhythmia may not exhibit any symptoms but symptoms may include:

  • Lightheadedness, dizziness or fainting
  • Palpitations, either extra or skipped heartbeats
  • Nausea or vomiting
  • Trouble breathing or rapid breathing
  • Fatigue and weakness
  • Chest pain
  • Sweating
  • Low blood pressure
  • Difficulty feeding
  • Cardiac arrhythmia symptoms may resemble other conditions. Talk to your child’s doctor and see a pediatric cardiologist if any abnormalities are detected.


During a physical examination, your child’s doctor may notice a cardiac arrhythmia before symptoms are noticeable and may recommend seeing a pediatric cardiologist. There are several different ways that cardiologists diagnosis arrhythmias.

  • Electrocardiogram (ECG or EKG): Electrocardiograms measure the electrical activity in the heart through electrodes placed on the chest, arms and legs. An ECG can show abnormal rhythms and stress on the heart. An ECG can be done a child who is lying down resting or exercising on a treadmill or stationary bike to see how the heart functions under stress.
  • Echocardiogram: Using an ultrasound, an echocardiogram creates an image of the heart and assesses the structure and function of the heart
  • Holter monitor: An ECG recording taken over 24 hours or longer is called a Holter monitor or event. Electrodes are attached to the chest and the child goes about his day while his heart activity is recorded.
  • Electrophysiologic study: A small catheter is inserted through a blood vessel in the arm or leg and guided into the heart to measure electrical activity and identify the source of the arrhythmia.
  • Tilt table test: A pediatric cardiologist may use a tilt table test for children who are fainting frequently. The test shows how the heart responds as the child lays flat or stands up.


Treatment options vary depending on your child’s cardiac arrhythmia. Some arrhythmias are harmless and do not require treatment. Others may require treatment to alleviate symptoms and discomfort. Treatments your pediatric cardiologist may recommend include:

  • Medication: Your child’s arrhythmia may be able to be regulated with medication.
  • Catheter ablation: Using a tiny catheter, a pediatric cardiac surgeon may guide special wires into the heart to disrupt the electrical circuit causing your child’s arrhythmia.
  • Electrical cardioversion: A controlled electrical shock may be given that briefly halts electrical activity in the heart and resets the natural pacemaker. The heart then restarts in a normal electrical pattern.
  • Pacemaker: A pacemaker is implanted in the chest for children and the abdomen for babies. The device has wires that attach to the heart and send electrical signals for a regular heartbeat.
  • Implantable cardioverter defibrillator: Also implanted in the chest, a cardioverter defibrillator tracks the heart rate. If the heart goes into a dangerously fast rhythm, the device sends an electrical shock that may be uncomfortable for the child but can save her life by stopping the rhythm.


After resting and recuperating from treatment, your child should go on to live a healthy life with no activity restrictions if approved by your pediatric cardiologist. Follow up care, including regular visits, may be recommended to monitor an untreated cardiac arrhythmia, ensure that your child’s heart continues to function well and replace batteries or check on a pacemaker or implantable cardioverter defibrillator.