There are many causes of premature heart beats in children, the most common being congenital factors, such as congenital heart disease, and some acquired causes, such as myocarditis, rheumatic fever, or the use of relatively toxic drugs, as well as after heart surgery. In addition, the lack of oxygen, acid-base imbalance, electrolyte disorders, exertion, autonomic dysfunction, and mental stress can also trigger premature heart beats in children. In most cases, premature heart beats do not affect children very much and are not life-threatening, such as occasional atrial or ventricular contractions, which can also be present in normal children. When children have premature heart beats, they often do not complain of obvious symptoms, but may complain of chest tightness or palpitations and precordial discomfort. If the number of premature beats tends to increase after activity, it is important to rule out the possibility of organic heart disease. In patients with premature beats, it is important to identify the type, form and number of premature beats. It is recommended to perform an ambulatory electrocardiogram to help assess the overall 24-hour premature heart rate. If the premature beats decrease or disappear after activity, medication may not be necessary. If the premature beats are caused by organic heart disease, or if the child has significant symptoms, and if the ECG shows multiple premature beats, then antiarrhythmic medication is recommended, depending on the type of premature beats. In the case of ventricular premature contractions, lidocaine and mexiletine may be used. For atrial premature contractions, propranolol or propafenone are recommended.