Pediatric arrhythmias, rhythm changes can be:
- Natural, that is, due to age or daily activities (sports, fever, stressful or highly emotional situations);
- Pathological, which require therapy and treatment as they are dangerous to health.
Arrhythmias present as tachycardias, that is, rapid heartbeats, or bradyarrhythmias, which involve slowdowns in heart rate.
In both cases, the arrhythmias can be symptomatic or asymptomatic in nature.
Some arrhythmias are benign, such as tachycardias and sinus arrhythmias, that accompany daily activities.
Pathologies of the pediatric heart, many arrhythmias can be dangerous and among these we can distinguish:
- Primary arrhythmias, which are due to an inherent defect in the electrical activity of the heart;
- Secondary arrhythmias, which can develop after heart surgery;
- Genetic arrhythmias;
- Arrhythmias due to specific pharmacological or physical alterations (eg therapies, drugs, feverish states).
The main tool for diagnosing an arrhythmia is the electrocardiogram, which records the electrical activity of the heart and can be time-dependent during examination by a cardiologist.
Tachycardias are characterized by a sudden increase in heart rate that can last from a few seconds to several hours and stop more or less abruptly.
The two main types of tachycardia are ventricular, which affects the ventricles, or supraventricular, which affects both the atria and the ventricles, the two chambers of the heart.
Tachycardias can degenerate into fibrillation, that is, into an extreme increase in rhythm, to the point of interrupting the electrical activity of the heart.
Therapeutic treatments are more or less invasive depending on the characteristics of the tachycardias.
They range from vagal interruption maneuvers to pharmacological or interventional therapy (transcatheter ablation).
Tachyarrhythmias with risk of malignant events belong to two families:
- Wolff-Parkinson-White (WPW) syndrome caused by the presence of abnormal cardiac conduction pathways capable of triggering rapid tachycardia up to cardiac arrest;
- Genetic channelopathies or arrhythmias (Long QT and Short QT Syndrome, Brugada Syndrome, Catecholaminergic Polymorphic Ventricular Tachycardia) abnormalities due to genetic mutations in heart cells that can cause tachycardia and cardiac arrest.
Bradycardias are less common than tachycardias and are caused by a malfunction of the atrial sinus node and the atrioventricular node, the two organs responsible for controlling heart rate.
Bradycardia can degenerate into cardiac arrest, so the therapeutic treatment for the most severe bradycardias can be the implantation of a pacemaker that allows artificial control of heart rhythm.
Among the bradycardias with the highest risk of malignant events is complete atrioventricular block, that is, a blockage of the transmission of the electrical signal from the atria, the upper chambers from which the cardiac impulse originates, to the ventricles, the lower chambers. of the heart that you are is not capable of its own rhythm.
When complete atrioventricular block occurs, which may be of genetic or growth origin, the ventricles considerably slow down their usual rhythm and, in the most severe cases, paralyze their activity.