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Atrial fibrillation (A-fib) is a type of arrhythmia, an irregular heart rhythm. A-fib causes the heart’s upper chambers (the atria) to beat very fast and irregularly. This condition is rare in children.
The specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine— the leading providers of pediatric heart care in Louisville and Southern Indiana — can help your child with atrial fibrillation.
The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute have the skills and experience to provide a pinpoint diagnosis and determine what treatment, if any, is needed for your child’s A-fib.
During atrial fibrillation, many electrical impulses around the atria cause these upper chambers to contract in a fast and hectic fashion that makes them vibrate. The atrioventricular node blocks most of these vibrations from reaching the heart’s lower chambers (the ventricles). So even though the atria are beating very fast, the ventricular heart rate — which causes your pulse — beats at a slower rate, usually less than 180 beats per minute. Sometimes the pulse rate is lower and may even be in the normal range, but it will still be irregular.
Symptoms caused by A-fib can include:
Sometimes symptoms are mild or there may be no symptoms.
This condition is rare in children, but it can occur in:
A pediatric cardiologist will perform a physical exam, listen to the heart and lungs, and perform any needed tests to make a diagnosis, including:
Possible treatments include:
Synchronized cardioversion delivers an electrical charge or “shock” to the heart to reset the heart’s rhythm. The shock interrupts the irregular electrical activity of the atria and helps restore a normal rhythm. The child will be sedated during this procedure and won’t feel any pain.
Medications used to treat or control atrial fibrillation may include:
Radiofrequency ablation is an option for some patients. This type of cardiac catheterization takes place in the electrophysiology lab during an electrophysiologic study:
If the A-fib does not respond to other treatments, a pacemaker may be surgically implanted. A pacemaker is a small device that’s connected to the heart with a thin wire. It sends small, painless amounts of electricity to the heart to make it beat the way it should.
If a patient does not respond to the previous treatments, the pediatric cardiologist may suggest a Maze surgery. This is an open heart surgery where the pediatric cardiothoracic surgeon makes small cuts in the upper part the atrium where the atrial fibrillation originates. The cuts create scar tissue that can stop the electrical atrial fibrillation transmission through the atrium.