Treating Your Child’s Arrhythmia

Many types of arrhythmia can be managed with either medication or ablation, a procedure that eliminates the small abnormal part of the heart that is causing the arrhythmia. Others require an implantable device, such as an ICD or pacemaker, to control the heartbeat and keep it steady. We provide all of these medical interventions, as well as the following:

• Genetic Counseling: As part of our multidisciplinary approach, genetic testing looks for abnormal variations in your child’s genes that may cause his or her abnormal heartbeat. Our genetic counselors look at your child’s unique gene variations to gain insight on the best treatments going forward, as well as to protect other family members who may be affected by the condition.
• Fetal Arrhythmia Program: In conjunction with our fetal cardiology team, we diagnose infants with heart rhythm irregularities prior to birth and treat babies before they are born. Sometimes this involves treating the expectant mother with antiarrhythmic medications.
• Inherited Arrhythmia Clinic: This comprehensive program is expressly designed to help children and families understand their inherited heart irregularity in all aspects—physical, emotional, and social. Cardiac genetic counselors, cardiac child psychologists, and electrophysiologists provide well-rounded care and support on how to best cope with the physical and lifestyle limitations that arrhythmia brings. We also identify other family members who may need care for the disease, and we work closely with our inherited arrhythmia clinic to provide full family care.
• Pediatric Heart Failure/Electrophysiology Program: Our program is nationally and internationally known as a leader in cardiac resynchronization therapy, a specialized pacemaker therapy that can help strengthen the heart in patients with heart failure who are awaiting heart transplants. We work closely with our pediatric heart failure and heart transplant teams to identify patients and also to treat arrhythmias. Patients come from all over the United States to take advantage of our wide breadth of deeply specialized physicians. These children often need a pacing device, a pacemaker or ICD.
• Pacemaker/ICD Clinic: We presently care for more than 350 patients with devices, all of whom have the peace of mind of continual data tracking, often in real time. Our clinic has had more than 1,400 pacemaker/ICD encounters (including both in-person visits and phone checks) in the last year.
• Outreach Clinics: To make it easier for patients, we travel to five clinics throughout the region and provide telehealth virtual visits to those farther away.
• Lead Extraction Program: As children with implantable devices grow, leads (wires) often need to be changed to avoid the chance of older leads malfunctioning or a child acquiring an infection from an outdated lead. The only pediatric program of its kind on the West Coast, we specialize in extracting old leads of implanted devices (pacemaker, ICD) and replacing them with new ones. Expert electrophysiologists, cardiologists, and cardiothoracic surgeons—trained in the latest lead-extraction methods—collaborate to minimize risk and replace leads in a hybrid catheterization lab that doubles as a sterile operating room, ready to handle any significant events that might occur, with the patient’s safety at the forefront. We employ the very latest laser technology to ensure that your child’s leads are removed safely and with the utmost accuracy.
• Pediatric Cardiac Psychology Program: We have a dedicated team of mental health experts to help patients and families cope with the changes brought by having an ICD. Stanford Medicine Children’s Health is part of the national effort to define evidence-based practices in mental health care through basic and translational science, education, leadership development, community commitment and engagement, and clinical innovation and service. Services include assessments, mental health counseling, community events, research, and resources.
• Second Opinion Program: For parents who want a second opinion, we are happy to review records or coordinate care directly with your child’s primary care physician. Once we complete diagnostics, we will share results with your child’s referring physician. Call (650) 721-2121 to schedule.
• Catheter Ablation: We perform more than 200 electrophysiology (EP) studies per year with an acute success rate of 98 percent (versus the national average of 95 percent). We minimize radiation exposure using a 3-D mapping system to aid in placing catheters within the heart during EP studies and ablations, substantially reducing radiation in children. We’ve dropped radiation exposure from approximately 20 minutes to two minutes per session. We also routinely use cryoablation (a freezing technique) in patients who are at high risk of damage to the normal conduction system, as it is a safer energy source for ablation.
• Telehealth Program: Families travel from across the nation to visit us. We make follow-up appointments consistent and convenient with virtual face-to-face consultations with our doctors via face time and telehealth visits.
• Adult Congenital Heart Disease Program: We understand the unique aspects of having childhood congenital heart disease and entering adulthood with complex needs. Besides our pediatric board certifications, we are board certified in adult cardiology and adult congenital heart disease. We help older children make a seamless transition to adult care by supporting them as they take on responsibility and then by introducing them to our counterparts at Stanford Health Care.