Doctor Betti Dr. Betti Hertzberg Ressler is a Board Certified Pediatrician on staff at Miami Children's Hospital. Dr. Hertzberg developed the toilet training video "Let's Go Potty." She is the co-author of "The Doctor's Book of Home Remedies for Children." Irregular Heartbeat Question: Is pediatric arrhythmia ever considered "normal"? Twice in the past week, I've noticed that my 5-year-old son's heatbeats were not spaced evenly. There seemed to be noticible pauses between sets of 4 or 5 beats. Other times, his heartbeats seem regular. Should I be concerned if he seems healthy otherwise? If I take him to see his pediatrician about this, what should I expect her to check? Diana Answer: Arrhythmia's, simply stated are variations of a regular heartbeat. Normally, the heart beats with a regular rhythm which helps pump and supply the body with blood. In children, it is not uncommon to find what is called a sinus arrhythmia. Sinus describes an area in the heart that is responsible for transmission of the electrical impulses that regulate heartbeat. In children, there are some things such as fever, medicines, anxiety, allergic reactions as well as exposure to certain chemicals or fumes that can cause the heart to have an irregular heartbeat. One thing that is very important when evaluating an arrhythmia is whether or not there are any symptoms. No mention was made of that. For example: The time you notice it (at play, rest or sleep, eating). All these things are important, together with listening with a stethoscope. This tool is invaluable because it amplifies all heart sounds, making it easier to hear different heart sounds and rhythms. Even with the aid of this instrument, it may not pinpoint the area of the heart that is responsible for the changes in rhythm. Because I have not examined your son, it would be a good idea to follow-through with your plan to see the pediatrician. According to what your son's doctor finds, she may or may not refer your son to the cardiologist. Again, please followup with the pediatrician. Also see: My 10 year old daughter is incredibly prone to insect bites. Even when no one else is getting bitten, they seem to go for her! Any suggestions? My 12 year old daughter experiences difficulty sleeping due to fear of the dark and being alone. Is this normal? Ask Dr. Betti your questions This information is not intended to be a substitute for visiting your pediatrician. If you or your child has specific concerns, you should see your doctor for a diagnosis and treatment.