Malignant arrhythmia in child

Malignant arrhythmias are disorders of a cardiac rhythm, which can lead to a cardiac arrest. They are usually developed in children due to hereditary syndromes like catecholaminergic polymorphic ventricular tachycardia or long QT syndrome. Unfortunately, up to 30 %, the first sign of this disease is a sudden cardiac arrest, which requires immediate intervention. Triggers of these acute states are common situations like higher physical activity, emotional burden, shock or even sleep.

Published at: 8.5.2020


Jana Djakow, MD, PhD
Deputy Head of Subsequent intensive care Department for Children, Hořovice Hospital, Hořovice, Czech Republic Department of paediatric anesthesiology and resuscitation, University Hospital Brno, Brno, Czech Republic ERC Paediatric Life Support - Science and Education Committee

The algorithm works with very realistic situation of sudden child collapse during sports activity and describes a case of the malignant arrhythmia in child. Although this is a very rare situation, the right initial steps and reactions of the rescuer are what can contribute by far the most to the survival of a child with a high quality neurological result. This makes the algorithm very useful. The algorithm is structured and logically organized. It shows all important steps - from the initial reaction of the rescuer to the postresuscitation care. Both correct and incorrect answers are presented with argumentation, which gives sufficient explanation. The language of the algorithm is sufficiently brief and compact and at the same time retains the necessary expertise in the terms used in Czech as well as in English version. Multimedia used the algorithm help to imagine and understand the idea of situation and complement algorithm appropriately.

In my opinion, all recommendations and argumentations correspond to the current guidelines of the European and the Czech resuscitation council and the knowledge we currently have about malignant arrhythmias in children. Of course, there is a possibility of need for an update of the algorithm after the publications of the new resuscitation guidelines 2021.


TRUHLÁŘ, Anatolij, et al. ERC Guidelines for resuscitation 2015: summary of recommendatitons. Intensive care medicine, 2015, 6-74.

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