Update on Arden’s Heart Rhythms
Shortly after Arden received diaphragm plication surgery at one week old, he developed ectopic atrial tachycardia, or E.A.T. for short. (Remember when I mentioned that I ran up a broken escalator at two weeks postpartum? Well, I just checked my journals, and it turns out that actually occurred only 11 days after Arden was born.) I ran to him, because his heart was beating over 200 beats per minute, and I’m no cardiologist, but I knew that wasn’t good. In layman’s terms, E.A.T. is a heart rhythm issue where the heartbeat originates in the “wrong” part of the heart, causing it to suddenly beat way faster than it should.
The first time Arden had an episode of E.A.T., his heart rate was around 250BPM for over 2 hours. The NICU called in cardiology and electrophysiology, and they discovered the E.A.T. by studying the waves on his electrocardiograms (ECG). After a while, Brodi and I began to be able to tell when he would flip into atrial tachycardia by watching his heart rhythms on the monitor. When he flipped into E.A.T., the “p wave” of his heartbeat would invert (turn upside down).
During his time in hospital, Arden was given 4 different meds for his E.A.T. Each time the med was changed, it was because the chosen medication and dose were no longer managing his random bouts of tachycardia. Although this was probably one of the least concerning parts of Arden’s hospital time, it is still incredibly scary to see your baby’s heart rate skyrocket like that. It meant that his heart was working too hard, and with his lungs already working way too hard, he didn’t need any other factors stacked against him.
Since being discharged from the hospital, Arden’s E.A.T has been managed by a med called propranolol. Since we have him constantly attached to an oximeter, we can monitor his oxygen saturation and his heart rate around the clock. Luckily, we have not noticed very many spikes in Arden’s heart rate since coming home. In January, Arden wore a holter monitor for 24 hours to see how his heart rhythms look over an extended period of time.
Yesterday Arden got another holter monitor test done, and also received another ECG. Luckily, this time we were able to do both of those things in Grande Prairie so that we did not have to make another trip to Edmonton. The results will be sent to and reviewed by Arden’s cardiologist and pediatrician.
Today our cardiologist called, and although we don’t have the results of yesterday’s tests yet, she is very optimistic about Arden’s heart rhythms since he has been home. The holter in January only showed 1 spike in his heart rate to 188BPM, and that was during a time when he was upset in his carseat. Although his heart was beating fast, it was still in sinus rhythm (normal heart rhythm). The cardiologist is very optimistic that Arden may have outgrown his E.A.T. By growing and gaining weight, he has almost outgrown the dose of propranolol that he is currently on. In fact, the dose that he is being given now (every 8 hours) is almost half the dose that they would start someone his size on to manage a heart rhythm issue. She suggested that it is very unlikely that if he were having any E.A.T episodes, that the propranolol dose he is on now would be able to manage it. This is all good news.
Our cardiologist will call us with an update in a few weeks, and we will see what the results of his most recent ECG and holter monitor reveal. However, all signs have been pointing in a positive direction. If Arden’s tests show no signs of E.A.T., we will likely begin a plan to take him off of the propranolol. Cardiology will continue to monitor him for the next 6-8 months to ensure that everything continues to go well. For now, I’m hopeful and optimistic that this will be another concern that we can cross off of Arden’s list!
XO, Rayel