Pediatric Dysrhythmias

Abstract

Arrhythmias in children are less common than in adults but are increasing because of successful repair of congenital heart diseases. Supraventricular tachycardia is the most common symptomatic pediatric tachyarrhythmia. Atrial flutter and atrial fibrillation in children are attributed largely to structural heart disease. Bradycardia is defined as a heart rate less than the lower limit of normal for a child's age, and the most common cause is sinus bradycardia. Despite the infrequent occurrence of arrhythmias, it is crucial to expeditiously identify and treat certain rhythm abnormalities because they can lead to further decompensation.

Orbital Trauma, Bradycardia, and Vomiting: Trapdoor Fracture and the Oculocardiac Reflex

“…Metabolic derangements such as hypoxia, hypothermia, acidosis, hyperkalemia, and hypercalcemia and endocrinologic disturbancesVmost notably, a hypothyroid stateVmay each precipitate bradycardia, although in this patient, none of these were suspected or, if tested, confirmed. 1 A number of neurologic conditions are known to result in bradycardia, and in this previously well patient who sustained a closed head injury, these warrant special attention. As alluded to in the case presentation previously mentioned, increased intracranial pressure must always be strongly considered in any patient with traumatic head injury presenting with bradycardia, as Cushing's triad of hypertension, bradycardia, and respiratory irregularity leading to apnea signifies elevated intracranial pressure until proven otherwise.…”

Paroxysmal Complete Atrioventricular Block: A Rare Cause of Syncope in Children

“…Bradyarrhythmias may also cause syncope. In children, high-grade AVB, either congenital or acquired, is the most commonly encountered cause of bradyarrhythmia causing syncope (6). The permanent form of high-grade AVB is a result of intrinsic disease of the AV conduction system [inflammatory, degenerative, congenital, etc] The electrocardiogram recorded during a syncope revealed two short complete atrioventricular block attacks (a).…”

Arritmias na criança

“…4,10,11 O diagnóstico diferencial que devemos fazer é com a taquicardia supraventricular com condução aberrante (menos de 10% das TSV), que pode cursar com QRS alargado.…”