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ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Dysrhythmias III: Characteristics of Dysrhythmias01:29

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Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
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Disturbances in Heart Rhythm01:29

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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
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Dysrhythmias II: Classification of Tachyarrhythmias01:28

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Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
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Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

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Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
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Dysrhythmias V: Evaluating Dysrhythmias01:30

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Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
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Related Experiment Video

Updated: Aug 27, 2025

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Atrial Flutter in Pediatric Patients.

Fabrizio Drago1, Pietro Paolo Tamborrino1

  • 1Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Piazza S. Onofrio 4, Rome 00165, Italy.

Cardiac Electrophysiology Clinics
|September 24, 2022
PubMed
Summary

Pediatric atrial flutter (AFL) is rare due to immature heart size, making it hard to study. Digoxin is a recommended treatment, sometimes combined with flecainide or amiodarone for better outcomes.

Keywords:
Atrial flutterChildrenTreatment

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Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Neonatal Medicine

Background:

  • Atrial flutter (AFL) is uncommon in pediatric patients because immature heart structures are insufficient to sustain the arrhythmia.
  • The low incidence of pediatric AFL presents challenges for clinical research and study.
  • AFL constitutes a significant portion of fetal (30%), neonatal (11%-18%), and older pediatric (8%) tachyarrhythmias.

Purpose of the Study:

  • To review the incidence and management of atrial flutter in pediatric populations.
  • To discuss current therapeutic strategies for pediatric atrial flutter.
  • To highlight the challenges in studying this rare pediatric arrhythmia.

Main Methods:

  • Review of existing literature on pediatric atrial flutter.
  • Analysis of epidemiological data regarding AFL incidence in different pediatric age groups.
  • Discussion of pharmacological and interventional treatment options.

Main Results:

  • Atrial flutter is a rare but recognized arrhythmia in pediatric patients, with varying incidence across different age groups from fetus to older children.
  • Transesophageal overdrive pacing shows a moderate success rate (60%-70%) for managing pediatric AFL.
  • Digoxin is a primary recommended medication to control ventricular rate, with flecainide or amiodarone used as adjuncts if digoxin alone is insufficient.

Conclusions:

  • Pediatric atrial flutter, though rare, requires specific management considerations.
  • Pharmacological treatment, primarily with digoxin, is a cornerstone of AFL management in children.
  • Combination therapy may be necessary for refractory cases, underscoring the need for tailored treatment approaches.