The term arrhythmia is commonly used in medicine for rhythm disorders in children. Cardiac arrhythmia usually occurs as a result of some kind of short circuit in the heart.
The heart normally beats continuously and regularly. In arrhythmia, the heart is too slow (bradycardia), too fast (tachycardia) or irregular. These rhythm disturbances cause symptoms such as fatigue, dizziness, and chest pain. Most arrhythmias do not require treatment, some cause health problems and should be examined and treated.
What Causes Rhythm Disorders in Children?
The conduction system in the heart ensures that the heart rhythm is regular. Electrical stimulation first starts from the sinus node (also called sinus node), which is in the right atrium and consists of a group of cells. The sinus node acts like a pacemaker. It ensures that the heart beats continuously and regularly. Normally, the frequency of stimulation from the sinus node increases in situations such as exercise and stress and the heart accelerates. During sleep, the frequency of stimulation decreases and the heartbeat slows down. Rhythm disorders in the heart may be short-term or permanent. It can be congenital or may occur later (acquired).
The conduction system of the heart ensures that the stimulating electrical current spreads to all the muscles of the heart within milliseconds. Symptom of Heart Rhythm Disorders
Rhythm disorder in the heart disrupts the function of the heart, brain and It disrupts blood flow to other organs. When the heart beats too fast, the chambers of the heart do not have the opportunity to fill. Even if it beats too slowly, it still cannot send enough blood to the body.
The following symptoms occur due to disruption of circulation:
- Dizziness
- Fatigue
- Weakness
- Feeling of dizziness
- Fainting
- Palpitation (fluttering or pounding sensation in the chest)
- Shortness of breath
Arrhythmia may be continuous, but it begins and ends suddenly and unpredictably. Some have no symptoms. In these cases, rhythm disorders are detected only during examination or tests.
What Should Be the Normal Pulse Rate?
Pulse rate refers to the number of heartbeats per minute. Normal pulse rate varies depending on the individual's age and life activities. As the child grows, the normal pulse rate decreases.
Normal pulse rate of children at rest:
Infant (0-3 months): 100-150/minute
Young child (1-3 years): 70-110/minute
Children < 12 years old: 55-85 per minute
Symptoms may appear when the heart rate of older children and adults drops below 50 beats per minute. On the other hand, the pulse may be slower in young athletes, it has no symptoms and is considered normal.
Types of Heart Rhythm Disorders
There are many types of arrhythmia.
Extrasystoles (Atrial Premature Beat and Ventricular Premature Beat)
Extrasystoles are called premature, that is, early beats. They are mostly considered minor heart rhythm disorders. The patient may feel fluttering or pounding in the chest. Atrial and ventricular premature beats are very common and can also be felt as a heartbeat pause. However, extrasystole occurs earlier than the expected normal beat. Early strokes are common and generally considered normal. However, sometimes it can be the first sign of an underlying health problem or heart disease.
Tachycardia
Tachycardia is an abnormally fast heartbeat, heart palpitations. Tachycardias are mainly of two types.
Supraventricular Tachycardia (SVT)
It is an extremely fast heartbeat originating from the upper chambers of the heart. SVT can start suddenly and last from a few seconds to several days. It is recommended to treat SVT if it recurs frequently and lasts for a long time.
Ventricular Tachycardia (VT)
Ventricular tachycardia originates from the lower chambers of the heart. It is a rare but very dangerous heart palpitation.
Bradycardia
Bradycardia is an extremely slow heartbeat. The main causes of bradycardia are as follows.
Sinus Node Dysfunction
The condition also called sick sinus syndrome is the sinus node not working well. It is a complication usually encountered after congenital heart disease surgery.
Heart Block
The situation where the heart's conduction cannot pass from the upper chambers to the lower chambers is cardiac block. It often occurs together with congenital heart disease. It also occurs as a result of other diseases and damages.
Diagnosis of Heart Rhythm Disorder
Many methods are used for diagnosis. Child's illness and family History (anamnesis) is very important. Evaluation begins with history and physical examination at the first doctor's examination.
If arrhythmia is suspected, an electrocardiogram (ECG) is taken to evaluate the electrical activity of the heart. While the ECG is being taken, the child lies on his back and electrodes are attached to the chest. Currents are transmitted from the electrodes to the machine via cables. Heart signals are recorded for a short time, usually around 10 seconds. The information is transmitted to the computer, where it is interpreted and a graph is drawn.
Other ECG tests may also be requested in the investigation of Rhythm disorders in children:
Resting ECG: Heart rate and rhythm are recorded while at rest for 1 minute.< br /> Exercise ECG: Also called a stress test, this type of ECG records heart rate and rhythm while cycling or walking on a treadmill.
Signal averaged ECG: Similar to a resting ECG test, heart rate and rhythm are recorded for 15-20 minutes. is monitored.
Holter ECG: It is generally an ECG recording lasting 24 hours or longer. Recording is made on a portable ECG device. The child is asked to continue normal daily activity. It is recommended not to swim, shower or get the electrodes wet. There are 2 types of holter ECG recordings. In continuous recording, the holter device records continuously. Event holter ECG is an ECG recording taken only when the child feels palpitations.
Treatment of Heart Rhythm Disorders
The child of arrhythmias does not require treatment. If necessary, treatment options are as follows.
Drug Treatment:
Antiarrhythmic drugs are determined according to the type of arrhythmia. Sometimes medications cause increased symptoms and side effects. For this reason, those using antiarrhythmic drugs should be closely monitored.
Pacemaker:
Pacemaker is a device powered by a small battery and placed near the surgical collarbone. It contacts the heart with a cable, detects when the heart rate is too slow and increases the heart rate.
Defibrillator:
Working with a small battery, its English name is implantable cardioverter defibrillator, commonly known as ICD. This device is similar to a pacemaker and is placed near the collarbone. The cable extends from the ICD to the heart. If the heart rate is dangerously fast or irregular, it detects this and sends an electric current (shock) to reduce the heart rate. It returns to normal.
Catheter Ablation:
A long, thin wire is advanced from the vein in the leg to the heart. Arrhythmias usually result from microscopic defects in the heart muscle. Once the problematic area is detected, the catheter neutralizes this area by freezing or heating it.
Schematic view of the catheter ablation process
Surgical Treatment:
In case all other options are not effective Surgical treatment may be considered. While under general anesthesia, the area causing arrhythmia is removed.
Symptom of Heart Rhythm Disorders
Heart rhythm disorder disrupts the function of the heart and disrupts blood flow to the brain and other organs. When the heart beats too fast, the chambers of the heart do not have the opportunity to fill. Even if it beats too slowly, it still cannot send enough blood to the body.
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