الفهرس 
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Abstract
The term ”arrhythmia” refers to any change from the normal sequence of electrical impulses. Cardiac arrhythmias have been classified into tachycardia and bradycardia. Mechanisms of tachyarrhythmias can be enhanced automaticity with triggered foci or enhanced conduction with the presence of reentrant circuits. Similarly bradycardia can result from suppressed automaticity or suppressed conduction, where normal conduction is delayed or blocked. The four main types of arrhythmia are premature (extra) beats, supraventricular arrhythmias, ventricular arrhythmias and brady arrhythmia .
There are many reasons for arrhythmias. Increased end diastolic pressures resulting in a trial or ventricular stretch, Valvular dysfunction, tumors, multiple surgeries, scarring and ischemia all play a significant role in arrhythmia generation. Cardiac swelling, pro-arrhythmic drugs, acid/base and electrolyte imbalance are also frequent etiologies of rhythm issues.
Arrhythmias can lead to myocardial dysfunction, heart failure, cardiac arrest, intra cardiac clot formation, seizures, syncope, and acquired cardiomyopathy. Only 5% of the emergency hospital admissions in the pediatric population is attributed to symptomatic arrhythmias.
We aimed to characterize patients attending pediatric arrhythmia outpatient clinic as regard:presence of cardiac rhythm abnormalities,pattern of cardiac rhythm abnormalities and impact of diagnosis and treatment on the patient morbidity.
This prospective observational study was conducted on 500 childern attending pediatric arrhythmia clinic this study conducted from 1st of October, 2016 to 30 of September, 2017 in the Pediatric arrhythmia outpatient Clinics in sohag university hospital we reported 150 (30%) cases had arrhythmia. The median age of children with arrhythmia was 5.83 years ranging from15 days to 18 years and 68 (45.33%) cases were females. Three hundred and fiftey cases have no arrhythmia , with median age 7 years ranging from one month to14 years ,168 (48.00%) cases were females . We performed a clinical analysis and reviewing the data of 500 cases attendening pediatric arrhythm out ppatient clinic and were subjected to complete clinical history including the cause of the referral, complete clinical examinations, Twelve leads ECG,investigation when indicated sush as serum electrolyte,Echocardiography,holter and electrophysiology.
In our study we found that ECG finding in our patients with arrhythmia is sinus tachycardia in 28 (18.67%) cases, atrial ectopics in 11 (7.33%) cases, WPW in 10 (6.67%) cases, 1st degree heart block in 10 (6.67%) cases, junctional ectopics in 8 (5.33%) cases, complete heart block in 6 (4.00%) cases, lateral infarction. In 6 (4.00%) cases, long QT syndrome in 5 (3.33%) cases, complete right bundle branch block in 4 (2.67%) cases, ventricular ectopics &long QT in 4 (2.67%) cases, wandering atrial pacemaker in 3(2%) cases, junctional, atrial ectopics 3 (2%) cases, ventricular ectopics 2 (1.33%) cases, 2nd degree heart block 2 (1.33%) cases, sinus bradycardia 2 (1.33%) cases, atrial fibrillation 2 (1.33%) cases, atrial flutter 1(0.67%) case and other types of arrhythmia 41 (27.33%) cases. In contrast to our results, ventricular ectopics were the most common type of arrhythmia observed in study of Premkumar et al. (2016), accounting for 30% of children.
One limitation to our study was that We do not reported the long term follow up due to limited duration of the study to one year.
Conclusion:
Cardiac arrhythmias in children can present at any age and the
recognition requires high index of suspicion. While majority of
children with arrhythmias have structurally normal heart, they are
frequently found in children with underlying heart disease.Diagnosis &prober management of pediatric cardiac arrhythmia have amajor impact on the patient outcome.