Updated: 01/27/2022

Hearing the word “irregular” in connection with your child’s health can be worrisome and frightening. Fortunately, most children, whose pediatricians identify an irregular heartbeat, are found to have conditions that are normal and harmless.

Some children outgrow an irregular heartbeat. Other times, the condition may be managed with medication. Your pediatrician may refer you to a pediatric cardiologist to diagnose the problem and manage the condition.

“The vast majority of children who are found to have an irregular heartbeat are normal and healthy,” says Robert Tozzi, M.D., a pediatric cardiologist at Hackensack University Medical Center’s Joseph M. Sanzari Children’s Hospital. “However, there are circumstances that make an evaluation by a pediatric cardiologist crucial. A pediatric cardiologist should be consulted for the following:

1. Syncope, or passing out, especially during exercise and sports
2. Chest pain with exercise
3. A family history of any of the following: sudden unexplained death, cardiomyopathy, long Qt syndrome, atrial fibrillation or Wolff-Parkinson-White syndrome.

What qualifies as an irregular heartbeat in children?

The term “arrhythmia” refers to an irregular heartbeat in a child or adult. If your child’s heart beats in an irregular way, the heartbeats may:

• be faster than usual
• be slower than usual
• have an unusual cadence

Many children who have an irregular heartbeat don’t experience it regularly. It may only happen in response to certain situations, or it may occur occasionally or randomly. If your child can explain when they notice any irregularities, it may help the doctor to diagnose the arrhythmia.

Why do some children have irregular heartbeats?

Sometimes, heart-rhythm problems run in families, so the cause could be genetic. Other times, an irregular heartbeat may be caused by:

• a fever
• an infection
• medication (over-the-counter or prescription)
• a chemical imbalance within the blood
• structural problems within the heart muscle
• disease or injury, which may affect the heart muscle
• stress in your child’s life

How is an irregular heartbeat in children diagnosed?

When you visit a pediatric cardiologist, your child may need to undergo the following tests:

• Electrocardiogram: an initial test done in the cardiologist’s office which records the heart rhythm for less than a minute.
• External monitor: A Holter monitor or event monitor is worn by the child for a period of time ranging from several days to several months
• Stress test: a test which evaluates the heart rhythm during exercise
• Echocardiogram: A test used to image the child’s heart in a safe and noninvasive manner.

What are the types of irregular heartbeats in children?

Many children are diagnosed with heartbeat irregularities including:

• • Sinus arrhythmia: This is the most common type of irregular heartbeat in children. It causes a faster heartbeat when children inhale, and a slower heartbeat when they exhale. It’s a normal finding that doesn’t require treatment.
  • Skipped beats: Your child may feel like their heart has skipped a beat, but it simply beats slightly sooner and more forcefully than expected. This is a common experience among children, and it doesn’t require treatment (as long as they are not very frequent).
  • Supraventricular tachycardia :Children with this condition have a faster-than-normal heartbeat, but it can be brought back to a normal rate with medication. Sometimes, when babies are diagnosed and treated, the symptoms disappear.
  • Long QT syndrome: This condition is less common and runs in families. It causes a child’s heart to beat very quickly. This syndrome may be managed effectively with medication. Sometimes, an implantable defibrillator may be recommended.
  • Wolff-Parkinson-White syndrome: This condition is rare and occurs when a child is born with an extra electrical pathway within the heart. This pathway can result in very fast and erratic heart beats. Medication may be helpful, but one medical procedure, an ablation, is curative.
  • Cardiomyopathy: This is a rare condition that is caused by an abnormality in the heart muscle.
  • Atrial fibrillation: This is more common in adults, but it can run in families, and be diagnosed in children.

What are common symptoms of irregular heartbeat in children?

Some children do not experience noticeable symptoms. Others may be too young to verbalize what they are feeling. Babies, for example, may seem tired, fussy, and have trouble eating.

For children who are able to notice their symptoms and describe how they’re feeling, the following signs may accompany an irregular heartbeat:

• feeling tired or weak
• feeling dizzy or lightheaded
• having palpitations or a fluttering feeling in the chest
• experiencing chest pain
• noticing that heartbeats feel fast, slow, or off-rhythm
• feeling short of breath or having trouble breathing
• appearing pale
• sweating
• feeling like they’re going to faint, or fainting

If your child’s symptoms are mild, you should follow up with your pediatrician right away. If your child’s symptoms are more severe or life-threatening, go to your nearest emergency department or call 9-1-1.

Next Steps & Resources:

• Meet our source: Robert Tozzi, M.D.
• To make an appointment with Dr. Tozzi, or doctor near you, call 800-822-8905 or visit our website.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.