Arrhythmias in Pediatric Age: A Narrative Review

Cardiac arrhythmias in the pediatric population represent both diagnostic and therapeutic challenges due to their heterogeneous etiologies, age-dependent clinical presentations, and the variety of management strategies required. Although many electrophysiological mechanisms are shared with adults, several arrhythmias are unique to infancy and adolescence or are associated with congenital heart disease and inherited channelopathies. Clinical presentation varies considerably with age and may be unclear or nonspecific, especially in neonates and infants. In some cases, arrhythmias are benign and self-limiting; in others, they may represent the earliest manifestation of an underlying cardiac disorder, potentially progressing to hemodynamic instability, serious arrhythmic events, or sudden cardiac death. Recent advancements in electrophysiology, catheter ablation, and device technology have broadened the therapeutic landscape, improving outcomes even in neonatal and infant patients. This review aims to summarize current knowledge on pediatric arrhythmias, with a focus on clinical recognition, diagnostic evaluation, and personalized treatment strategies.