A certain beat or rhythm keeps your heart healthy so that it can carry on its function smoothly. If the pace is irregular, the heart might beat too fast or too slow or just miss a beat. Heart rate can differ depending on factors like child’s age, overall health, and activity level like whether the child is resting or moving at the time the pulse is taken. Even emotional wellbeing can have an impact on heart rate. The heart rate is seen to increase when the child is excited. Abnormal heart rate is not rare among the children. Their heart will slow down or speed up now and then. However, when the pace becomes faster than what has been considered normal for a particular duration, it could be a sign of a problem. Therefore, it is important to understand and differentiate the normal and abnormal heart rate in children.
heart rate

What Is Heart Rate In Children?

Heart rate or pulse is the number of times the heart beats per minute. By taking the pulse, doctors can tell important things about your child’s health.
What Is The Normal Heart Rate In Children?
The age group determines the ‘normal’ average heart rate of children. As a newborn grows into a toddler and then a youngster, the normal heartbeat varies. Heart rate has a tendency to decrease from the newborn to adolescence. The following chart (source) helps you to get an idea about the average heart rate (pulse rates) for children under different age groups.

‘Heart Rate’ In Children
Age(Year) Awake rate (beat per min(bpm)) Sleeping Rate(beat per min (bpm))
Neonate (less than 28 days old) 100-205 90-160
Infant (1 month to 1 year old) 100-190 90-160
Toddler from 1 to 2 years old 98-140 80-120
Preschooler from 3 to 5 years old 80-120 65-100
Children from 6 to11 years old 75-118 58-90
Adolescent ( around 12-15 years old) 60-100 50-90

What Is Arrhythmia In Children?

The healthy heart should beat powerfully with a regular rhythm. Abnormal heart rate with irregular (too fast and too slow) rhythm is called Arrhythmia. If the pulse is too high, it is called tachycardia, or too low, it is called bradycardia.
The heartbeat is handled by electricity. Distinctive cells known as pacemakers discharge electrical energy that rushes through the heart muscle, bringing about contractions. As the contraction of muscles takes place, the heart pumps the blood.
Mostly arrhythmia is harmless, but sometimes it can be dangerous and even turn fatal as the irregular flow of blood can damage the vital organs like the kidneys, heart, brain and the liver.
An arrhythmia can happen as a result of cardiac issues or due to an infection, certain medicines or even fever. Even if your child has been continuously crying and playing, it can alter his heart rate for some time. This is not harmful and the heartbeat will get back to normal after a few minutes of rest.
If an irregular rhythm occurs, it may point towards some the underlying issues. It is essential to discover what type of abnormal heartbeat it is. Treatment depends on its type.

Types Of Arrhythmia

There are two types of Arrhythmia:

  1. Tachycardia
  2. Bradycardia
What Is Tachycardia In Children?

Tachycardia occurs in children when the heart beats too fast. Generally, this condition will not lead to the heart stopping all of a sudden, and it does not last for a long time in order to cause any serious organ damage.
Basically, there are two main types of tachycardia:

  1. Ventricular tachycardia: This involves ventricles only. Here,
    • Fast heart rate starts in the ventricle
    • Not common among children but can be serious
    • Occurs among children who have serious heart problems
  2. Supraventricular tachycardia (SVT): SVT involves both the atria and the ventricles. SVT is a very a common type of tachycardia in children and it is otherwise known as paroxysmal atrial tachycardia. Here,
    • Rapid rhythm starts above the ventricles
    • Both the heart chambers – the upper and the lower are involved
    • Begins and ends suddenly

    There are different types of SVT. Some of the main types include:

    • Atrioventricular reentry tachycardia (AVRT): This is due to an additional electrical circuit that joins the atrium and ventricle without passing through the AV node. In this case, fast heart is caused because the impulse move at the same time through two pathways
    • Atrioventricular nodal reentry tachycardia (AVNRT): Here, fast heart rate is due to an additional electrical circuit similar to AVRT. The only difference is that in AVRT, the AV node is not involved, whereas, in AVNRT, the AV node is involved
    • Atrial flutter: Atrial flutter is caused when an abnormal conduction circuit develops in the atrium, resulting in atria to beat extremely fast. As a result, atria does not get enough time to push the blood to the ventricles. Consequently, ventricles will not be filled. As a result, body cells may not be able to receive enough blood
    • Atrial ectopic tachycardia: Here, the impulse starts somewhere other than the sinus node in a small abnormal cluster of cells. The signals are sent to the atrium and the atrium contract before it ought to be resulting in a faster heartbeat
    • Junctional ectopic tachycardia: Here the abnormal cluster of cells are positioned in or near the AV node. Here the ventricle is contracted too quickly before it’s supposed to be
What Is Bradycardia In Children?

Bradycardia refers to a heart rate lower than the normal range for the age of the child. The heart rate will fall below 50 bpm. For some children, a slower heart rate does not bring on any problem. However, bradycardia can also indicate issues with the heart’s electrical framework. It implies either the heart’s natural pacemaker is not working in the approved manner or that the electrical pathways of the heart are interrupted. In severe types of bradycardia, the heart beats become too slow that it does not pump sufficient blood to satisfy the body’s requirements. This can cause complications and can be life-threatening.
heat rate in children

When To Take Your Child’s Pulse?

Usually, there is no need for you to check your child’s heart rate. The doctor will be doing it during well checkups. But if your child has a medical condition that requires you to monitor his heart rate from time to time, your doctor will tell you when and how to take the pulse. You should take a pulse of your child if:

  • If your child complains of heart palpitations
  • He feels that heart is skipping a beat
  • Has chest pain and feels dizzy
  • He is not asthmatic but has trouble breathing
  • He suddenly becomes unconscious or blacks out
  • His skin turns pale and lips become blue

Take your child’s pulse immediately and let your doctor know about this and also the activity that caused these symptoms.

How To Take Your Child’s Pulse?

For taking your child’s pulse, you will need a watch or a stopwatch. If your child was physically active, then wait for a few minutes for the heart rate to return to normal. To feel a pulse, press your pointer and middle finger on a major artery in the body. You will feel a throbbing sensation when you locate a pulse.

  • To take a pulse you should first know the different pulse points. There are different areas on the body from where you can read a pulse. Some of them are: on the neck, on the wrist, in the armpit or in the crease of the elbow
  • Once you have located the pulse, begin counting the beats for 30 seconds. After 30 seconds, stop. Note down the number of beats and double it to get the per minute heat rate. For example, if you have counted 40 beats in 30 seconds, then your child’s heart rate in a minute would be 40 X 2= 80 beats per minute. So the heart rate of your child would be 80
How Is Arrhythmia In Children Diagnosed?

Along with medical history and physical examination of your child, the doctor will use various procedures to diagnose abnormal heart rate in children:

  • Electrocardiogram (ECG ) : It is the measurement of electrical activity of the heart. An ECG can indicate any abnormal heart rate or any type of heat condition in your child.ECG can be done as Resting ECG or Exercise ECG / Stress test
  • Holter monitor: This is an ECG recording over a period of 24 hours or more. Holter monitoring is of two types: Continuous monitoring where ECG is recorded throughout the testing period or event monitor in which ECG is recorded only when the child starts to feel any symptoms or abnormal heart rate is detected
  • Electrophysiology study (EPS): This is an invasive test in which a catheter is inserted into the blood vessel anywhere in the leg or the arm that leads to your child’s heart. This test helps to find out from where the arrhythmia is originating in the heart. This way doctor will be able to determine the correct way of treating the condition
  • Tilt table test: Tilt table test is recommended to children with regular episodes of fainting. This test helps to determine in what ways the blood pressure, oxygen levels and heart rate in the children changes with any change in the position i.e. lying down or standing up. While performing this test, intravenous medication will be administered to your child to prevent him from fainting
How To Treat Abnormal Heart Rate In Children?

The treatment of arrhythmia in children is usually determined by:

  • The age of the child
  • The type of arrhythmia
  • The frequency of arrhythmia
  • The symptoms

Abnormal heart rate or arrhythmia in children can be treated by using:

  • Medicines that correct the abnormal heart rate
  • Catheter ablation: Here a catheter is inserted through a vein from the leg that leads to the heart
  • Pacemakers: Here the doctors use implant devices such as pacemakers that help the heart to beat normally. If irregular heart beat is caused by small issues in the heart muscle, then the problem area is pinpointed and the catheter heats or freezes the defective cells and destroys it
  • Defibrillators: This involves placing a small battery operated device called the implantable cardioverter defibrillator (ICD) near the collarbone. Wires run from the defibrillator to the heart. The defibrillator sends electrical shock to the heart if the heart stops beating or beats in an abnormal way
  • Surgery: Surgery is only recommended when all the other options have failed
When To Seek Medical Attention

Regardless of the physical activity, if your child’s heart rate is too fast to count or slow, then it is better to get it checked by a doctor. Sometimes abnormal heart rate can indicate underlying heart problems in your child which should not be neglected.