Likely to resolve without treatment. And potentially the harbinger of a life-threatening condition. Ventricular tachycardia in children with structurally normal hearts presents a management challenge. To help clinicians make informed decisions despite the relatively sparse data on idiopathic VT, the Pediatric and Congenital Electrophysiology Society and the Heart Rhythm Society formed a writing committee of 13 experts who analyzed the literature, assessed diagnostic and treatment options, and recently published a consensus statement.
The evaluation should begin with a detailed family history, a lead ECG, an echocardiogram, a hour Holter monitor and, if indicated by history or basic testing, an MRI or lab exercise testing.
Clues from the family history and the evaluation tests determine the next course of action for pediatric cardiologists. Ventricular arrhythmias may clinically present as conditions such as premature ventricular contractions PVC. However, if a Holter monitor reveals that more than 10 percent of heartbeats over a hour period are PVCs, then the child should be followed carefully due to the risk of developing ventricular dysfunction.
Options then include frequent monitoring, or if treatment is needed due to symptoms or declining function, medication or an electrophysiology study and cardiac ablation to remove tissue where the arrhythmia is originating can be employed. Concussions: Why is early intervention important? Conditional reprogramming and airway epithelial cells Congenital hearing loss: Diagnosis and treatment Congenital heart disease management Congenital heart disease screening For our team, Connor's sports injury was no match.
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He concluded: "This extensive document covers all aspects of paediatric arrhythmias and is a working document for physicians who diagnose and treat these patients. We explain how to perform the different procedures, the indications, and how to manage complications. Centres can use it as a check list to ensure they have the equipment and experience needed to effectively treat this specialised patient population.
Journal EP Europace. Your child will lie down while electrodes are connected to the ECG machine by wires. The ECG records the heart's electrical activity for a minute or so. Stress test exercise ECG. Your child is attached to the ECG machine as described above. He or she will walk on a treadmill or pedal a stationary bike while the ECG is recorded. This test is done to check the heart during exercise.
Holter monitoring. Your child will have his or her heart rhythm checked over 24 to 48 hours. A small portable monitor is worn while your child goes about his or her usual activities. Electrophysiologic study EPS.
For this test, the doctor puts a small, thin tube catheter into a large blood vessel in an leg or arm. The doctor moves the catheter to your child's heart. This test can find out the type electrical signal causing the problem, and where the signal is.
Tilt table test. This test may be done if your child faints often. The test checks your child's heart rate and blood pressure as he or she changes position. Echocardiography echo. This test uses sound waves to make detailed pictures of your child's heart structure and function. Implanted loop recorder. This heart monitoring device may be used when the doctor thinks your child is at high risk for arrhythmia and other testing has not given a straight-forward result.
This test may only be used in children who are high risk. The device is put under the skin. Itis used for long-term monitoring. It will also depend on how severe the condition is.
Some children don't need treatment. If your child needs treatment, he or she will likely be cared for by a pediatric cardiologist. Treatment may include:. Radiofrequency ablation. This procedure uses a special catheter to destroy the tissue causing the abnormal electrical signals.
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