Pediatrics

Arrhythmia Management & Electrophysiology Service

Customized care for heart rhythm disorders

If your child has been diagnosed with an arrhythmia, or an abnormal heart rhythm, you’re likely to be concerned. The NewYork-Presbyterian Arrhythmia Management and Electrophysiology Service is dedicated to diagnosing and treating heart rhythm disorders in children and adolescents. Our experienced pediatric electrophysiologists care for children with a wide range of arrhythmias, from those with occasional episodes of palpitations to patients with complex cardiac arrhythmias, including heart rhythm problems after open-heart surgery. Using the latest diagnostic and therapeutic approaches, we customize a plan of care to give your child the best chance for a long, healthy, and productive life.

About our program

The Arrhythmia Management & Electrophysiology Service, operating across NewYork-Presbyterian Morgan Stanley Children’s Hospital and NewYork-Presbyterian Komansky Children's Hospital, is one of the largest programs of its kind in the New York metropolitan region. Our expert pediatric electrophysiologists provide comprehensive, compassionate, multidisciplinary care to young patients with arrhythmias. We begin with diagnostic testing to determine the type and location of the abnormal heart rhythm. Armed with that knowledge, we tailor a customized treatment plan for your child using medication, ablation, the implantation of a pacemaker or other devices to restore a normal rhythm to your child's heart. With timely diagnosis and the right treatment, children with arrhythmias lead full and active lives.

What is an arrhythmia?

An arrhythmia is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slowly, or with an irregular rhythm. When a heart beats too fast, the condition is called tachycardia. When a heart beats too slowly, the condition is called bradycardia.

Arrhythmias may occur at any age, although the condition is far more common in adults.

Symptoms of arrhythmia in children

Children with arrhythmias often experience no symptoms, or they can’t express the problem. Often, an arrhythmia is discovered as part of a child’s physical exam, or through another encounter with your child’s pediatrician.

Symptoms of arrhythmia may include:

Weakness
Fatigue
Heart palpitations
Lightheadedness or dizziness
Low blood pressure
Syncope (fainting or temporary loss of consciousness)
Paleness
Difficulty feeding (in infants)
Slow heartbeat
Fast heartbeat
Heartbeat that skips

Types of arrhythmias we treat

At NewYork-Presbyterian, we treat a full range of heart rhythm disorders in children and adolescents, including:

Arrhythmias after surgery for congenital heart disease
Arrhythmias related to hypertrophic and dilated cardiomyopathy
Brugada syndrome
Catecholoaminergic polymorphic ventricular tachycardia
Fetal arrhythmias
Heart block
Hypertrophic and dilated cardiomyopathy
Long and short QT syndrome
Supraventricular tachycardia
Ventricular tachycardia
Wolff-Parkinson-White syndrome

How we diagnose arrhythmias

To diagnose your child’s arrhythmia, our physicians may ask you about your medical and family history, which can help establish your child’s risk for arrhythmia. In addition to invasive electrophysiologic studies, our team performs non-invasive diagnostic procedures in children with palpitations or syncope (fainting or temporary loss of consciousness). These procedures include:

Electrocardiograms (EKG or ECG)
24-hour Holter monitoring
Event recording
Stress testing

How we treat arrhythmias

Medical Therapies

Some children's arrhythmias respond to treatment with medications. We may need to try different drugs before we identify which medication works best for your child.

Interventional Therapies

Interventional therapies such as ablation procedures can effectively treat and often permanently cure arrhythmias by eliminating the cause of the abnormal rhythm.

During an ablation procedure, which we perform in a pediatric catheterization lab, our pediatric electrophysiologist inserts catheters into the child's veins via the groin and advances them toward the heart. The catheters electrically stimulate the heart to induce the abnormal rhythm that has been causing the child's symptoms.
The pediatric electrophysiologist interprets the rhythm, and then delivers energy via the catheter, using either radiofrequency energy or cryotherapy (freezing temperatures). These therapies eliminate the cause of the abnormal rhythm and can permanently cure your child's problem.
To ensure your child is comfortable during the procedure, we perform most studies under anesthesia delivered by an experienced pediatric anesthesia team. We have performed these procedures in children of all ages, including young infants.

Implantable Devices

Our electrophysiologists also have expertise in the diagnosis and treatment of children with slow heart rhythms and different types of heart block that may require the implantation of a pacemaker.

When the heart rhythm is too slow, a pacemaker can stimulate the heart, preventing symptoms.
For children with certain conditions that can lead to a life-threatening fast arrhythmia, we may use a permanent implantable cardiac defibrillator (ICD). An ICD can potentially save a child's life by sensing and treating a life-threatening arrhythmia.

Why choose us

Extraordinary experience in pediatric electrophysiology

Our pediatric electrophysiology team is specifically trained in performing electrophysiology procedures in children, which requires an in-depth knowledge of anatomical development and the use of smaller catheters. We routinely provide second opinions and treat patients with complex conditions who have not found successful treatment elsewhere.

Less Invasive and Safer Approaches to Care

NewYork-Presbyterian is at forefront of developments in technologies that have made arrhythmia treatment less invasive, with lower radiation exposure. Today, our pediatric electrophysiologists perform most arrhythmia ablation procedures with 3D mapping technology, which eliminates the need for fluoroscopy imaging and the radiation exposure it involves.

Translational Research in Pediatric Cardiac Care

NewYork-Presbyterian’s pediatric heart specialists are international leaders in pediatric cardiac research initiatives and discoveries to advance the care and improve the lives of our young patients with heart disease. Our teams participate in trials of arrhythmia therapies and implantable devices, as well as quality outcomes and safety metrics registries.