PEDIATRICS Vol. 79 No. 1 January 1987, pp. 84-88
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Medicolegal Problems in the Management of Cardiac Arrhythmias in Children

Arthur Garson Jr MD1

1 From the Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston

Malpractice actions against pediatricians treating patients with arrhythmias have been recurrent in four general areas. Optimal medical management may not be widely recognized. Cases illustrating the following concepts are presented. (1) Intravenous verapamil therapy in babies may cause apnea, hypotension, and bradycardia; (2) continued episodes of atrial flutter in a child may cause sudden death; quinidine may be related to the death; (3) children with "familial seizure disorders" may in fact have the long QT interval syndrome. The QT interval must be measured on the ECG in patients with unexplained seizures; (4) "supraventricular tachycardia with aberration" is uncommon in children. Rapid heart rates with QRS complexes that are different from the sinus complexes are likely to be ventricular tachycardia. These situations must be recognized as potential problems and must be treated appropriately.

Key Words: cardiac arrhythmia • malpractice • verapamil • ventricular tachycardia • atrial flutter • law

Submitted on January 24, 1986
Accepted on April 11, 1986




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