Pediatric Arrhythmia Program at the Children's Heart Center
The Pediatric Arrhythmia Program at Phoenix Children's Hospital diagnoses and treats children with congenital heart disease who have heart rhythm problems.
What is Arrhythmia?
Arrhythmia, also called dysrhythmia, is an abnormal heartbeat where the heart rate becomes too slow, too fast, or occasionally unstable.
Types of Arrhythmia in Children
There are many different kinds of abnormal heart rhythms. If an abnormal rhythm occurs, it's important to find out what kind it is. Treatment recommendations depend on its type. Many simple and infrequent arrhythmias require no therapy and some are even normal physiology, such as sinus arrhythmia. Other arrhythmias can cause the heart rate to be irregular, fast or slow. Fast rhythms are called tachycardia. Slow ones are called bradycardia.
Below is a list of common arrhythmias:
- Premature atrial contraction (PAC) and premature ventricular contraction (PVC)
- Supraventricular tachycardia (SVT)
- Wolff-Parkinson-White syndrome (WPW)
- Ventricular tachycardia (VT)
- Sick sinus syndrome
- Complete heart block
How do you treat Arrhythmia?
Many arrhythmias go away spontaneously and only require occasional checkups or a short course of medications. Others can be persistent and can require long term medications for control or catheter based procedures for definitive therapy.
A common way of treating arrhythmia is with catheter ablation. During ablation, a doctor inserts a catheter (thin, flexible tube) into the heart. A special machine delivers heat (radiofrequency ablation) or cold (cryothermal ablation) energy through the catheter to tiny areas of the heart muscle that cause the abnormal heart rhythm. This energy destroys (or ablates) the small piece of heart tissue which was causing the abnormal rhythm.
- Catheter ablation can be used to treat AV Nodal Reentrant Tachycardia (AVNRT): an extra pathway which lies in or near the AV node, which causes the impulses to move in a circle and re-enter areas it already passed through. This is the most common form of supraventricular tachycardia in teenagers and young adults.
- Supraventricular tachycardia (SVT) from an Accessory Pathway: Extra pathways can exist from birth that connect the atrium and ventricles. The extra pathway may allow electrical signals to travel between the atrium and ventricle rapidly. This is frequently the cause of supraventricular tachycardia (SVT) in babies and young children, especially in those who also have Wolff-Parkinson-White syndrome.
- Atrial fibrillation (AF) and atrial flutter (AFL): Extra signals originating in different parts of the atrium cause the atria to beat rapidly (atrial flutter) or quiver (atrial fibrillation).
- Ventricular tachycardia: a rapid, potentially life-threatening rhythm originating from impulses in the lower chambers of the heart. The rapid rate prevents the heart from filling adequately with blood so that less blood is able to circulate through the body.
Bradycardia, or slow heart rate, can be normal in older children and athletes. In people with abnormally slow heart rates due to injury to the normal heart conduction system, pacemakers can be used to restore the heart rate. However, pacemakers cannot repair or restore the normal conduction system. Occasionally, special multi-lead pacemakers can be used to assist heart function in people with congestive heart failure (CHF). This type of pacing is know as cardiac resynchronization therapy (CRT) or biventricular pacing.
Internal Cardiac Defibrillator
In rare cases where someone has an unstable or life threatening heart rhythm abnormality or is at high risk for developing one, a special pacemaker, called an internal cardiac defibrillator (ICD), can be implanted. The ICD has the ability to shock someone out of a dangerous rhythm. People requiring this type of device often suffer from congestive heart failure, ventricular tachycardia or have significant impairment of heart function due to congenital heart disease. These devices can also be lifesaving in people with inherited or genetic disorders such as long QT syndrome, Brugada syndrome, arrhythmogenic RV dysplasia (ARVD), and hypertrophic cardiomyopathy (HCM) which puts them at risk for life threatening arrhythmias.
Additional Pediatric Arrhythmia-Related Programs:
Some children may be at for life threatening arrhythmias because of an inherited condition in the sodium, calcium, or potassium channels inside the heart. Conditions such as long QT, Brugada syndrome and catecholaminergic ventricular tachycardia require the expertise of a cardiologist with specific training in these ion channel defects. Treatment may include medications, activity restrictions and possibly an internal cardioverter defibillator.
Home Monitoring Pacemaker/Defibrillator Follow-up Program
Patients with pacemakers and defibrillators can be followed for routine and urgent matters related to their device from anywhere in the United States with a simple land-line.
- In 2010, more than 180 electrophysiologic studies were performed for a variety of electrical conditions.
- 95 percent of our ablations result in a "cure," avoiding the need for life-long anti-arrhythmic medication therapy.
- Drs. Andrew Papez, Edward Rhee and Mitchell Cohen evaluate children at risk for sudden cardiac death and offer comprehensive evaluation for families at risk.
- Dr. Cohen and team have implanted more than 600 pacemaker/defibrillators and currently follows nearly 350 patients in a pacemaker clinic, providing comprehensive outpatient care for these patients. Patients can also be followed with the latest remote home monitors to minimize outpatient visits and hospitalizations.
Physicians and Clinical Team
Mitchell I. Cohen, MD – Section Chief, Cardiology
Edward Rhee, MD - Electrophysiology and Pacing
Andrew Papez, MD - Electrophysiology and Pacing
Jennifer Shaffer, CPNP - Electrophysiology and Pacing
Cardiology / Cardiothoracic Surgery
Cardiology / Cardiothoracic Surgery(602) 933-3366