Arrhythmias in children can be life-threatening if not identified and treated promptly. In this video, Dr. Supratim Sen, Senior ...

life-threatening-pediatric-arrhythmias-explained-dr-supratim-sen

Life Threatening Pediatric Arrhythmias Explained | Dr. Supratim Sen

hello I am Dr supratim sen senior consultant pediatric cardiology at narana Health srcc Children's Hospital at Mumbai today I'll be discussing life-threatening pediatric arhythmia the normal heart rhythm as you might know is a synchronized contractility of the heart initially the receiving Chambers or the Atria will fill up with blood they then pass on the blood to the pumping Chambers the ventricles and then the ventricles will eject this blood to the rest of the body and to the lung and this is based on the electrical conduction system of the heart now the normal electrical conduction can be interrogated with a normal ECG and the ECG has five waves pqr s and t and a normal ECG is known as a sinus rhythm all patients who have a normal Rhythm will have a sinus rhythm Arias are any abnormal Rhythm and when we talk about lifethreatening Arias we basically talking about the fast heart rates so this is an ECG of an SVT an SVT you can see has the waves very close together and that means that this patient has a heart rate of nearly 300 per minute svts can be life-threatening uh because if the heart goes on at this speed for prolonged periods of time you can have dysfunction of the heart muscle the patient can become lethargic uh they can have increased sweating respiratory distress and finally they can even progress to a shock so we need to treat this on an urgent basis we can use an injection to try to terminate this SVT we can also give these patients a shock known as a cardiov version and then to prevent recurrence of the SVT we will continue a medication known as a beta blocker so that these patients are protected from future SVT in older children there is also an invasive procedure known as a radio frequency ablation where we can treat the cause of this SVT which is a kind of like a short circuit within the conduction system also known as an accessory pathway now coming to the more dangerous type of arhythmia that is the ventricular tachicardia and the ventricular fibrillation these are heart rates where the patient immediately loses cardiac output and they lose Consciousness and in the children this is commonly seen in patients who have cardiac channelopathies channelopathies are ION channel disorders they are genetically trans mited and there's a wide variety but the commonest are the Long QT syndromes and these patients can have abnormal Baseline ECGs but the clinching diagnosis is if you do an ECG during the episode you'll see the characteristic ventricular takic cardia and fibrillation which is a very desynchronous chaotic type of a rhythm so it loses its normal rhythmic synchronicity which we see in the normal ECG now this is an emergency where you have to shock the patient immediately to get the normal Rhythm back some of these patients can revert to normal Rhythm spontaneously and then the patient might just present to us with recurrent Syncopy and interestingly a lot of these patients have first referred to the pediatric neurologist because the initial diagnosis is actually epilepsy and only once the neurologist thinks that okay this is not a rain condition they refer to us for the cardiac evaluation and treatment now these Arias the ventricular Arias are we prevent this by again beta blockers long term but patients who have recurrence of Arias on beta blockers we do a surgical procedure known as a sympathetic denervation or a cervical sympathectomy and that prevents the surges of noradrenaline and adrenaline from the nerves into the heart and even if that is unsuccessful in stopping the Aras completely then the final treatment in these ventricular takic cardia patients is a defibrillator which is is like a pacemaker but it gives tiny shocks to normalize the Rhythm now obviously this is all very technical but it's important for a person to know about this be aware about this so that we can suspect these uh in the patients diagnose it and treat it appropriately thank you [Music]

Dr.

Related Videos

Consultation & Treatment

Consult With Loading Doctor Data