Abnormal Heart Rhythm

Arrhythmia

Signs and Symptoms
Diagnosis
Treatment

Treatment

The treatment prescribed for your child will depend on the type and severity of your child's arrhythmia or irregular heart rhythm and the results of tests including an electrophysiology study. You and your doctor will decide which treatment is right for your child. The following are treatments that may be considered.

Medications

Certain anti-arrhythmic drugs change the electrical signals in the heart and help prevent heart abnormalities from causing irregular or rapid heart rhythms.

Follow-up Study

To make sure the medication is working properly after two or more days in the hospital, your child may return to the Electrophysiology Laboratory for a follow-up study. Our goal is to find the drug that works best for your child. On occasion, we will admit a child to the hospital and monitor the heart rhythm when administering a new medication. More frequently, patients begin taking medication without hospitalization.

Radiofrequency Catheter Ablation

Radiofrequency catheter ablation (RFA) is a technique to treat arrhythmia that was pioneered at UCSF Medical Center. It disrupts part of the electrical pathway causing irregular heart rhythms, providing relief for patients who may not respond well to medications, who prefer not to take medications or who can't take medications.

The procedure involves threading a tiny metal-tipped catheter through a vein or artery in the leg and into the heart. Using fluoroscopy or X-ray, doctors guide the catheter through a blood vessel to the heart. Additional catheters, inserted through the vein in the leg and the neck, contain electrical sensors to find the area causing the arrhythmia. This is called mapping.

The metal-tipped catheter is maneuvered to each site in the heart that causes the irregular heartbeat. Radiofrequency waves or current is sent through the tip of the catheter, cauterizing or burning cells to destroy the extra electrical pathways that cause abnormal heart rhythms. In most cases, patients leave the hospital within 24 hours or the same day.

RFA has been proven very effective in treating children with arrhythmias. Your doctor will discuss this treatment and others with you to decide the best option for you or your child. For conditions like Wolff-Parkinson-White syndrome, in which a hair-thin strand of tissue creates an extra electrical pathway between the upper and lower chambers of the heart, RFA ablation offers a cure. It has become the treatment of choice for patients with that disorder.

Cryoablation

Cryoablation, sometimes referred to as cryo, is similar to radiofrequency catheter ablation (RFA) in that it is a procedure that disrupts the abnormal electrical pathway in the heart. This newer technology has been used in the Electrophysiology Laboratory at UCSF Children's Hospital since March 2004.

Instead of burning cells, however, cryoablation destroys cells by freezing them and has been very effective in treating children with arrhythmias. Your doctor will discuss this treatment and others with you to decide which method is the best option.

Like RFA, cryoablation involves threading a tiny metal-tipped catheter through a vein or artery in the leg and into the heart. Doctors guide the catheter through the blood vessel to the heart by using fluoroscopy or X-ray.

Additional catheters, inserted through the vein in the leg and the neck, contain electrical sensors to help "map" or find the area causing the arrhythmia. The metal-tipped catheter is maneuvered to areas in the heart that cause the irregular heart rhythm. Then, cryoablation freezes the cells or extra electrical pathways that cause abnormal heart rhythms. In most cases, patients leave the hospital within 24 hours or the same day.

Pacemaker

Implantable devices or pacemakers work on "demand" to treat slow heart rhythms. These small devices are implanted beneath the skin, below the collarbone or in the abdomen. They're and connected to a pacing wire positioned inside the heart via a vein or outside the heart. The pacemaker delivers a small electrical impulse to stimulate the heart when it beats too slowly, generating a regular heart rhythm.

Implantable Cardioverter-Defibrillator

This is a device for children who are prone to life-threatening rapid heart rhythms. It is slightly larger than a pacemaker and usually implanted under the skin below the collarbone. It is connected to a pacing wire inside the heart via a vein. It can deliver an electric shock to the heart when it determines the heart rate is too fast. It also can pace or stimulate the heart when it beats too slowly.