Pediatric Heart Expert Forum
PAC's in infants
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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PAC's in infants

My son was in the special care nursery after birth due to a crash c section and he needed a little help after delivery (full term 40 weeks and 3 days). During his 3 day stay in special care it was noted that he was having occasional PAC's and also a low resting heart rate (when sleeping it would dip to 70's but would come up- respirations and O2 sat remained normal).  He had an EKG which showed  PAC's- more than the doctor would like to see.  No PVC"s were noted and he was in normal sinus rythmn.  He now has to have a holter monitor which I am hoping is done soon.  I am very worried.  What could this mean?  Is this something that he will have for life or will he outgrow this? Is he more at risk for SID's? Treatment?  
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Generally, premature atrial contractions (PACs) are a benign issue in newborns.  They are commonly seen, even without a stressful delivery.  If the underlying ECG is normal, except for the PACs, then it is unlikely to represent an underlying heart problem.  Most PACs go away a few weeks or months after birth.  Occassionally a baby will be prone to an abnormal rapid heart rate called SVT (supraventricular tachycardia).  The purpose of the holter monitor is to count how many extra beats the baby is having and if any SVT is present.  Statistically this should not cause a problem for your baby.  If the holter is not normal (ex: SVT is seen or the PACs account for more than 10-15% of the overall rhythm) then an assessment by a pediatric cardiologist would be indicated.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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The Children’s Hospital of Philadelphia
Philadelphia, PA
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