- Arrhythmias (rhythm disorders)
Arrhythmia is an abnormal heart rhythm. Children may be born with rhythm disorders such as a fast heartbeat (tachycardia), a slow heartbeat (bradycardia) or an irregular heartbeat, or rhythm disorders may occur at any time. Rhythm disorders are called arrhythmias. In the diagnosis of arrhythmia, electrocardiogram (ECG), 24-hour ECG (Holter), exercise test (exertion test) and electrophysiological study methods are used.
- What are the causes of arrhythmia?
Most of the arrhythmias are seen in children with structurally normal hearts. However, it is known that arrhythmias are associated with heart abnormalities in some children. Therefore, it should be investigated whether there is a heart abnormality in a child presenting with arrhythmia. In addition, the patient is questioned about any medication use that may cause arrhythmia, excessive caffeine intake, tobacco and stress factors.
- Are there hereditary types of arrhythmias?
Certain types of arrhythmias and heart diseases can be hereditary and can be seen much more frequently within the same family (can be passed from mother or father to child). It is also known that some gene defects cause certain arrhythmias and heart diseases. If such diseases are encountered, the entire family is scanned for this disease and, if necessary, the gene defect can be investigated by contacting the center that performs the test. Long QT syndromes can be given as examples of these diseases.
- What kind of complaints or symptoms do arrhythmias cause?
Complaints or symptoms It can be light or heavy. It may cause rapid heartbeat, chest palpitations, weakness, dizziness, blackout, fainting or chest pain.
- What are normal and abnormal heart rhythms?
Normal sinus rhythm: It is the heart rhythm created by electrical impulses originating from the sinus node located at the top of the right atrium. While this node stimulates 70-110 times per minute in older children, the rate increases slightly as the age decreases.
Sinus arrhythmia: Increased heart rate fluctuations that occur with breathing. It is observed more frequently in younger children. It is thought to be normal.
Sinus tachycardia: It is a heart rate higher than the normal heart rate determined for that age, originating from the sinus node.
Sinus bradycardia: Originating from the sinus node It is a heart rate lower than the normal heart rate determined for that age.
Supraventricular extrasystole: Premature contractions originating from the atria. It is common in healthy children. It rarely causes symptoms.
Supraventricular tachycardia (SVT): It is an attack of rapid heartbeat originating from the upper cavities of the heart (atria). It can be as short as seconds or last for days. At this time, the heart rate is usually above 150 beats/min. There are many reasons.
Wolf-Parkinson-White syndrome (WPW): It is the most common cause ofSVT in children. It occurs due to the presence of an extra muscle band in addition to the normal conduction pathway between the atria and ventricles. This is a band of muscle that is too small to be seen during echocardiography. However, it can be understood from ECG. While it may disappear spontaneously during infancy, it rarely resolves spontaneously after infancy.
AVNRT (AV nodal cyclic tachycardia): It is mostly seen in adults. It is rarely seen in babies. It occurs due to an extra path within the AV node. It occurs and ends very suddenly.
Atrial flutter: It is rare in children. It is caused by an abnormal electrical cycle within the atria. It is benign in the neonatal period and usually resolves spontaneously within 1-2 years. It is generally observed at older ages in patients who have undergone surgery due to complex heart anomalies.
Atrial fibrillation:It is rare in children. It is an irregular SVT that occurs due to numerous irregular electrical impulses originating from the atria. It rarely has familial forms. It may also occur after heart surgery. Ventricular extrasystoles (VES) are premature beats originating from the ventricles. Although it is also seen in children with normal hearts, it may cause an abnormality. It should be investigated as it may be a symptom.
Ventricular tachycardia: These are regular and fast heartbeats originating from the ventricles. It can be short or long term. It can often be seen together with an underlying heart disease.
Ventricular fibrillation: It is an irregular and very dangerous high-speed heart rhythm originating from the ventricles. In this case, the heart cannot contract sufficiently and cannot pump blood.
Heart block: The electrical impulse starting from the upper part of the heart (from the right atrium) passes through certain conduction pathways until it reaches the lower ventricles. If there is a block at any point in these pathways, the electrical stimulus coming from above cannot be transmitted to the lower ventricles. Therefore, the harmony between the atria and ventricles is disrupted. In this case, the lower ventricles generally contract at a much lower rate than the upper atrium.
Sick sinus syndrome: The speed of electrical impulses coming out of the sinus node becomes very slow due to damage to the sinus node due to a certain heart disease or surgery. There are excessive pauses. It may cause abnormally low heart rates.
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