Atrial fibrillation living in children

Overview

Atrial fibrillation (say: ay-tree-al fib-ruh-LAY-shun) is a condition where the heart beats in a fast, irregular way. Normally, the heart beats in a steady rhythm. In atrial fibrillation, the top parts of the heart (the atria) quiver instead of contracting properly. This can make the heart pump less effectively. In children, this is rare but can happen, often linked to other heart problems.

Atrial fibrillation is very uncommon in children. It is much more common in older adults. When it does occur in children, it is usually related to an underlying heart problem or after heart surgery.

Atrial fibrillation in children can affect those born with heart defects, those who have had heart surgery, or children with other conditions like hyperthyroidism (overactive thyroid). It can also occur in teenagers for unknown reasons.

Symptoms

Common symptoms

• A fluttering or pounding feeling in the chest (palpitations)
• Feeling tired or weak
• Shortness of breath
• Dizziness or lightheadedness

Symptoms in children

• Children may not be able to describe what they feel. They might say their heart is 'racing' or 'jumping'.
• They may become irritable, pale, or sweaty.
• They might feel tired quickly during play or sports.
• Some children have no symptoms at all and the AF is found during a checkup.

Symptoms in older adults

• In older adults, symptoms often include chest pain, confusion, or fainting.
• Older adults may also have no symptoms, but AF increases stroke risk significantly with age.

Causes

Main causes

• Congenital heart disease (heart defects present at birth)
• After heart surgery (especially in the weeks or months following)
• Inflammation of the heart muscle (myocarditis) or the lining around the heart (pericarditis)
• Overactive thyroid (hyperthyroidism)
• Electrolyte imbalances (like low potassium or magnesium)

Risk factors

• Having a heart defect that affects the structure of the heart
• Having had surgery to repair a heart problem
• Infections that affect the heart
• Rare genetic conditions that affect the heart's electrical system
• Conditions like obesity or high blood pressure (more common in teens)

When to see a doctor

See a doctor urgently if:

• If your child complains of chest pain, fainting, or has a very fast heartbeat that does not slow down
• If your child has trouble breathing or seems unusually pale or sweaty without a clear cause

Book a routine appointment if:

• If your child has occasional palpitations (feeling of skipped or extra beats) that come and go quickly
• If your child seems more tired than usual during physical activity
• If you notice your child's heartbeat seems irregular during a checkup or at home

Diagnosis

Doctors diagnose atrial fibrillation by checking the heart's rhythm. They will ask about symptoms and listen to the heart. The main test is an electrocardiogram (ECG or EKG), which records the heart's electrical activity.

Tests that may be done

• Electrocardiogram (ECG) – a quick, painless test that shows the heart's rhythm
• Holter monitor – a portable ECG device worn for 24–48 hours to catch irregular beats that come and go
• Echocardiogram (echo) – an ultrasound of the heart to check its structure and function
• Blood tests – to look for thyroid problems, electrolyte imbalances, or other causes
• Event recorder – a device worn for weeks or longer to record symptoms when they happen

What to expect at your appointment

Your child will likely see a pediatric cardiologist (a heart doctor for children). The tests are non-invasive and painless. The doctor will explain the results and discuss the best treatment plan. You will have time to ask questions.

Treatment

Treatment for atrial fibrillation in children focuses on controlling the heart rate, restoring normal rhythm when possible, and preventing blood clots that can cause strokes. The plan depends on the child's age, symptoms, and any underlying heart condition.

Self-care at home

• Keep track of your child's symptoms – note when they happen and how long they last
• Encourage your child to stay active but rest when tired
• Make sure your child drinks enough water and eats a balanced diet
• Avoid caffeine and energy drinks, which can trigger irregular heartbeats
• Follow the doctor's advice about returning to sports or physical activities

Medical treatments

Medicines may be used to slow a fast heart rate, help the heart beat more regularly, or reduce the risk of blood clots. These treatments are chosen based on your child's specific health needs. Always give medications exactly as prescribed by your child's doctor. Do not change doses or stop without talking to the doctor.

When is surgery considered?

In some children, a procedure called catheter ablation may be considered. This uses a thin tube (catheter) to deliver energy to the small area of the heart causing the irregular rhythm. This can sometimes cure atrial fibrillation. It is reserved for children who do not respond well to medicines or have frequent symptoms.

Living with this condition

Most children with atrial fibrillation can live a normal, active life. Regular checkups with a heart doctor are important. Your child may need to avoid certain sports or activities if the heart rhythm is not well controlled. The doctor will give clear advice on what is safe.

Lifestyle tips

• Promote a heart-healthy lifestyle: healthy eating, regular physical activity, good sleep
• Limit screen time and encourage active play
• Teach your child to recognize symptoms and tell an adult if they feel unwell
• Keep a symptom diary to help the doctor adjust treatment

Diet and exercise

A balanced diet with plenty of fruits, vegetables, and whole grains supports heart health. Avoid too much sugary or caffeinated drinks. Exercise is generally encouraged, but your child's doctor may recommend avoiding very intense competitive sports if the heart rhythm is not stable. Always ask the doctor for specific exercise guidelines.

Mental health and emotional wellbeing

Living with a heart condition can be stressful for children and families. Your child may feel anxious, different from peers, or worried about symptoms. It is normal to have these feelings. Talk openly with your child and ask the doctor or a counselor for help if needed.

Prevention

Atrial fibrillation in children cannot always be prevented, especially if it is due to a heart defect or after heart surgery. However, managing underlying conditions like hyperthyroidism or infection may help. A healthy lifestyle can reduce the risk of heart disease later in life.

Screening programmes

There is no routine screening for atrial fibrillation in children. However, children with known heart conditions are monitored closely by their heart doctor.

Complications

If left untreated

• Blood clots that can travel to the brain and cause a stroke (rare in children but possible)
• Heart failure – the heart cannot pump blood well enough to meet the body's needs
• Very fast heart rate that can cause fainting or damage to the heart over time

Long-term outlook

With proper treatment and follow-up, most children with atrial fibrillation do very well. Many lead full, active lives. In some children, the condition may go away on its own, especially if it was triggered by a temporary cause like an infection. Your child's heart doctor will guide you on the best care to keep your child healthy and safe.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.