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Cardiac Arrhythmias (Other arrhythmias (Rare, Atrial fibrillation, Atrial…
Cardiac Arrhythmias
Supraventricular Tachycardia
Misc
Most common arrhythmia in children
Types
AVRT
WPW
Cause of hydrops fetalis and intrauterine death
S+S
HR = 250-300
Cardiogenic shock
Ix
ECG
Narrow complex tachycardia
HR = 250-300
May be able to discern a p wave after QRS
Upward delta wave in WPW
T wave
inversion
lateral leads
If heart failure is severe
Echo
Structural heart disease is rare but must be ruled out
Mx
A-E
Vagal manouvres
Carotid massage
Cold ice pack to face
Blow into syringe
80% effective
IV adenosine
Treatment of choice
DC cardioversion
Only if adenosine fails
0.5-2J/Kg
Ablation
In adolescents
Congenital complete heart block
Rare
Anti-Ro and anti-La antibodies from mother
Suspect if maternal Hx of connective tissue disorder
Likely to affect
future pregnancies
Abnormal development of conducting system
Atrophy + fibrosis of AV node
May cause fetal hydrops and IUD
Endocardia pacemaker for symptomatic children
Long QT syndrome
Autosomal dominant
Channelopathy
Potassium
Calcium
Sodium
Sudden LOC
Associated with stress, emotion or exercise
If unrecognised can lead to death from VT
Other arrhythmias
Rare
Atrial fibrillation
Atrial flutter
Ectopic atrial tachycardia
Ventricular tachycardia
Ventricular fibrillation