Neonatal and Pediatric Guidelines for Arrhythmia Management

Arrhythmias are relatively common in the pediatric cardiac intensive care unit. Grosse-Wortmann et al studied 494 patients revealing 59% of neonates and 79% of older children have arrhythmias within 24 hrs of surgery. Of these arrhythmias, junctional ectopic tachycardia (JET) was seen in 9% of neonates and 5% of older children. Ventricular
tachycardia was found in 3% of neonates and 15% of older children (Gross-Wortmann, 2010). Primary arrhythmias occur in children without structural heart disease, although they may be secondary to ion channel diseases that are still being elucidated. Risk factors that predispose children for secondary arrhythmias include congenital cardiac malformations, surgical repair and scarring, long cardiopulmonary bypass times, or exposure to chronic hemodynamic stress (Brugada, 2013).