Disorders of heart rate and rhythm.

The clinical approach to a child with a disorder of the heart beat is still that of a careful history, physical examination, and an ECG with a long rhythm strip. A diagnostic approach is presented which is based on rate, rhythm, and mechanism. Newer diagnostic methods are presented as well as advances in the basic cellular electrophysiology. Disorders of automaticity, triggerable cells, and re-entry are analyzed. Finally, therapy is revised for conventional drugs, and new and nonapproved drugs are listed. Indications and limitations for cardioversion, electrical pacing, and surgery are presented.