Bradycardia in children

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Submitted by Dr T on May 25, 2013 – 9:28am

Question: 
My son is 3 years old and has airway problems. He had a Type 3 Laryngeal cleft repair in 2012. Otherwise, he seems to be fine. A few months ago we noticed that his heart rate started dropping into the 60’s and 50’s during the night and staying there. EKG was done and was normal. His oxygen stays in the 96-100 range, no issue there. While in the hospital, I noticed on the heart monitor it kept saying “Sinus rhythm”, “SV Rhythm”, and SV Brady. His heart rate did not drop down though like it does at home & I think it’s due to his albuterol and recemic epi breathing treatments there as well as steroids. He is on Amoxicillin and Prednisolone currently. The dr’s do not take me serious when I ask them about this issue. Any advice?

The monitor read-outs reflect a variation in your son’s heart rate, not an interpretation of what it means. A normal heart rhythm in children varies quite a bit based on age as well as activity level. A resting heart rate is typically between 60 – 100 bpm. With activity, the heart rate may get as high as 200 bpm. During sleep, the heart rate can occasionally drop as low as 30-40 bpm. An EKG will show whether this a normal variaition or the result of abnormal electrical conduction within his heart.

In adult non-athletes a heart rate <60bpm is called bradycardia. The most common cause of bradycardia in children and teenagers is called sinus bradycardia. Most of the time this is a normal heart rate variation. In addition, the heart rate normally slows during rest or sleep. Abnormal bradycardia in children and infants, especially premature babies may be associated with other illnesses.

From your doctor’s response it appears these heart rate changes are normal variations and not something to worry about. The questions to ask your doctors:

  • Is thew heart conduction normal?
  • Is this a normal variation?
  • Are his other problems causing his heart to beat slowly? (I doubt it).

Hope this helps,

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