Your Child's Heart Rhythm Monitoring

The heartbeat is the strong, rhythmic pattern of heart squeezing to pump blood to the body and lungs. It’s controlled by electrical signals in the heart. The rate or pattern of the heartbeat is known as the heart rhythm. Abnormal heart rhythms are called arrhythmias. These can cause your child to have symptoms such as lightheadedness, dizziness, low blood pressure, fainting, or fatigue. Rarely, arrhythmias can cause more serious problems. To help the doctor learn more about your child’s heart rhythm, tests can be done. These include:

During an ECG, leads are placed on the chest, arms, and legs to check for problems with your child’s heart rhythm.

• Electrocardiography (ECG or EKG). This test records electrical signals from your child’s heart onto a paper strip. The pattern of these signals can help the doctor tell whether your child’s heart is normal, under stress, or experiencing electrical or rhythm problems. This test can also show problems with the pumping mechanism of the heart. The test lasts about 10 minutes.
• Holter monitoring. A Holter monitor is a portable device that records your child’s heart rhythm continuously for 24 hours. This device helps the doctor check for arrhythmias that occur frequently but randomly. It is a device you can wear away from the doctor's office. It continuously monitors the heart rhythm while it's being worn and gives a summary of how many heart beats your child had in 24 hours, both regular and irregular. It is also an opportunity for your child to alert an adult about an abnormal feeling in his or her heart, by pressing the button on the holter. This allows us to create, what we call, symptom/rhythm correlation. Ask for the handout created by the cardiology team titled How to Set Up Your Child’s Holter Monitor.
• Event monitoring. An event monitor is a portable device that records your child’s heart rhythm when symptoms occur. It’s generally used for periods longer than 24 hours, up to a month. This device helps the doctor check for arrhythmias that occur randomly and infrequently. When symptoms occur, you can activate the button to record the heart rhythm at that moment.

Your child’s experience: Electrocardiography (ECG or EKG)

• Before the test. Your child will change into a hospital gown for easy access to the chest.
• During the test. Your child lies still on an exam table. Electrodes (small sticky pads) are placed on your child’s chest, arms, and legs. The electrodes record your child’s heart rhythm during that moment in time, and a paper prints the heart rhythm for the doctor to review. After the test. Unless told not to, your child can return to his or her normal routine. The doctor may give you early results after the test. You’ll receive complete results when the EKG has been fully reviewed.

Your child’s experience: Holter monitoring or event monitoring

• Before the test. You may need to take your child to the hospital to receive the Holter or event monitor. Arrangements may also be made with an outside company to mail an even monitor to your home. With a Holter monitor, the electrodes are connected from the monitor to your child’s chest. The monitor is normally worn around the waist on a belt or over the shoulder in a bag. A mesh vest may be given to your child to wear under his or her clothes to protect the monitor from being damaged. With an event monitor, electrodes may or may not need to be connected to the chest. Your child may have one that is worn on the body like a Holter monitor, or one that he or she carries.
• During the test. Your child should continue with normal daily activities. We encourage your child to be active while wearing the monitor so we can see a full range of heart rates. You or your child will need to keep a written log of these activities. The monitors cannot get wet, so it is important you either defer bath time until after the monitor time is over, or remove the monitor for bathing and reconnect the monitor after. We can provide you with a diagram to do this confidently. Remove the Holter or event monitor as instructed by your child’s doctor. An event monitor that is not worn on the body should be held against the chest when symptoms occur. A button is pressed to record your child’s heart rhythm for 1 minute. Always follow your doctor's directions to get the most accurate reading from the monitor.
• After the test. Return the Holter or event monitor when the test is complete. The heart rhythm recorded by the monitor and the activity log are then compared and analyzed. Your child’s doctor will follow up with you with complete results.