Heart Rate and Rhythm Disorders.

Abstract

1. Philip Wackel, MD* 2. Bryan Cannon, MD* 1. *Pediatric Cardiology, Mayo Clinic, Rochester, MN * Abbreviations: AV: : atrioventricular AVR: : accelerated ventricular rhythm ECG: : electrocardiogram PAC: : premature atrial contraction PVC: : premature ventricular contraction QTc: : corrected QT SVT: : supraventricular tachycardia VT: : ventricular tachycardia 1. Proper evaluation of pediatric rhythm disorders can be challenging and requires knowledge of what tests are available and most appropriate to aid in this challenge. (1) 2. Correctly identifying common normal variants in the rhythm and distinguishing them from common abnormal findings is needed to properly triage and treat patients. After completing this article, readers should be able to: 1. Identify by history the symptoms concerning for rhythm disorders. 2. Select appropriate tests in the evaluation of suspected rhythm disorders. 3. Discuss common benign findings and appropriately limit testing/referrals. 4. Describe common rhythm disorders and potential associated underlying problems. Rhythm disorders in pediatric patients encompass a vast and diverse group of problems that vary greatly not only in etiology but also in presentation. These disorders can range from bradycardia to tachycardia but also include inherited channelopathies as well as rhythm disorders associated with underlying congenital heart disease. With such a diverse group of potential problems and the high degree of variability in presenting symptoms, the evaluation and diagnosis of rhythm disorders can be difficult. As with most medical issues, starting with a thorough history and physical examination will help guide the need for further evaluation and testing to reach the appropriate diagnosis. The presentation of arrhythmias varies depending on the type of arrhythmia, but even within the same arrhythmia there can be significant variation in presenting symptoms. Palpitations are a common complaint in the pediatric population, but most patients with palpitations do not have an underlying arrhythmia. Determining which patients …