Abstract
Fast or irregular heartbeats in childhood may be described as palpitations or fluttering in the chest or throat; they may or may not represent true arrhythmias. Documentation of these symptoms as true arrhythmias is imperative before treatment can be instituted but is difficult if these symptoms occur less than once a day or for a duration of less than one hour. No therapy is indicated if the symptoms arise from occasional ectopic beats or variations of sinus rhythm, and selection of those patients for whom therapy is indicated, as well as the selection of antiarrhythmic medication, is dependent on demonstration that the arrhythmia originates from a supraventricular or ventricular focus.

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