All these changes make it an appropriate time to re-consider for recognition and management of tachycardias in infancy and childhood. Diagnosis and Natural History of Tachycardia Precise diagnosis is of fundamental importance to management of tachycardias. Analysis of a 12 lead electrocardiogram recorded in sinus rhythm and in tachycardia, coupled with knowledge of the age of onset of symptoms will often lead to a precise diagnosis. Knowing the diagnosis, one can define the natural history and plan treatment. Ventricular tachycardia in infancy is rare.
Atrioventricular reentry is also the commonest tachycardia encountered in children of school age.
Other arrhythmias are less common at this age but they require precise diagnosis. Choice of Treatment Most tachycardias in childhood are not life threatening. Decisions about treatment are based on symptoms, taking account of the frequency, duration and severity of episodes. In infants in particular, it is important to be aware of the natural history as a long term strategy is not required for a tachycardia with a high chance of spontaneous resolution. In childhood it is important also to take account of the disruption to school and family life by attacks of tachycardia and of anxiety produced in children and their families by each episode.