When a child complains of a racing or irregular heartbeat, a parent’s concern is understandable. A fast heart rate in children in most situations is a normal response to increased levels of activity or, occasionally, anxiety. However, at times this could be a sign of a heart rhythm disorder that requires medical attention.
We see two types of irregular heartbeats in children. An irregular heartbeat due to premature beats is fairly common, but on occasion can be a sign of more significant disease or of poor heart function. If a child experiences a sustained rapid heartbeat when he or she is just sitting, or if a young person is exercising and the rapid heartbeat continues long after they stop, this may be the sign of something more problematic.
An abnormal rapid heartbeat can occur at any age, but the peak age tends to be in the teen years. Younger children often describe the rapid heartbeat as a “beeping” in their chest. Older children and teenagers describe “heart racing,” and often associate the sensation with chest pain.
Parents should contact their family’s pediatrician when a child complains of a racing heartbeat, and the pediatrician then will refer the patient to a cardiologist. If the diagnosis is not evident after standard, non-invasive testing, the next step for the cardiologist will be an attempt to capture an episode through the use of a portable 30-day heart monitor.
The most common heart rhythm problem for young people is supraventricular tachycardia (SVT), which is due to an abnormal wiring in a child’s heart. When children who play sports experience SVT, they should stop their activity until the episode terminates. SVT is often associated with a serious heart rhythm disorder known as Wolff-Parkinson-White syndrome (WPW), which can lead to sudden death if not treated.
Once we understand what our patients are dealing with, there are several ways to treat a heart rhythm disorder. Some children can simply stop a rapid heartbeat on their own. Medications are also available to control the heartbeat. Both SVT and WPW can be treated with catheter ablation — a procedure done with catheters through the blood vessels where the heart is mapped electrically and the pathway causing the problem is eliminated, leading to a cure for the disorder. St. Louis Children’s Hospital performs about 150 catheter ablations a year, with a 98 percent success rate.
To learn more about children and heart rhythm disorders, visit stlouischildrens.org/Heart.