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When Your First Abnormal Heart Rhythm Treatment Didn't Work

portrait of gregory supple
Gregory E. Supple, MD

Ever feel like your heart skipped a beat? Or like it was pounding so fast it was going to pop out of your chest?

Chances are, you were having an abnormal heart rhythm, or an arrhythmia. This occurs when the electrical impulses that control your heartbeat malfunction. You might feel like your heart is beating too quickly, too slowly or irregularly. Arrhythmias can be entirely harmless, but they can also be sign of an emergency. In these cases, your arrhythmia will be treated depending on the type and cause of the irregular heartbeat.

Treatments include medications, surgery, or implanted devices that help regulate your heartbeat. You might also have an ablation—a procedure during which a physician inserts a tool that “burns off” the patch of heart tissue generating the abnormal electrical signals. These treatments are often successful, but what happens when you’ve tried treatment and it didn’t work? Below are five things to do if you have a stubborn arrhythmia.

Five Things to do if You Have a Stubborn Arrhythmia

Make sure you are working with the right care team

If you have mainly been working with a primary care physician or cardiologist, it might be time to talk to someone more specialized.

Cardiac electrophysiologists are specifically trained in the mechanism and performance of electrical activities in the heart. They’re uniquely qualified to diagnose and treat abnormal heartbeats.

Not quite sure where to start looking for an electrophysiologist? Ask your physician, or check out the treatment teams at Penn to find highly qualified electrophysiologists.

Consider multiple options

Arrhythmias can be treated in a number of ways. “Oftentimes, we have people use a combination of ablation and medications—it doesn’t have to be one or the other,” says Gregory E. Supple, MD, an electrophysiologist at Penn Medicine.

Also, don’t get discouraged if treatment doesn’t work instantly. “It’s hard to say, ‘This is going to be successful right away’,” says Dr. Supple. “Sometimes, we need to finish up and then go back for another procedure, especially if you have heart damage and we’ve been working for a while.”

Give your lifestyle some love

Did you know arrhythmias can be triggered by emotional or physical stress?

Your mental and physical health can play a big role in arrhythmias, including your diet and exercise routines.Couple cycling outdoors

“While arrhythmias aren’t always terribly affected by diet or exercise, there are certain substances that can make arrhythmias worse,” says Dr. Supple.

When it comes to exercise, Dr. Supple recommends talking to your physician.

“Exercise is important for keeping your heart healthy. But if you have certain types of arrhythmias, exercise can sometimes make it worse,” he says. “If you have an arrhythmia, ask your doctor before you start or stop exercise routines.”

Keep your heart healthy

Many arrhythmias are benign— they don’t increase your risk of other heart problems. However, some types of arrhythmia increases your risk of stroke, cardiac arrest and heart attack.

It is important to work with your physician to figure out what type of arrhythmia you have. And as always, it’s important to take care of your heart.

Make sure you cut your risk of heart disease with these strategies:

  • Reduce high blood pressure
  • Stay at a healthy weight
  • Stick to a heart-healthy diet
  • Avoid smoking
  • If your physician clears you for exercise, enjoy regular physical activity

Do not lose hope

Having an abnormal heart rhythm that doesn’t respond to treatment can be uncomfortable and frustrating. But that doesn’t mean that all hope is lost, or that you will never be able to treat it.

“We are constantly working on different variations of treatment to make it better,” Dr. Supple says. “The ablations we do now are better than the ones we did just five years ago. We have better tools, can treat more forms of arrhythmia, and can do it safely. It’s not perfect, but we are always improving.”

Keep talking to your cardiologist. He or she might know of new breakthroughs or treatments. Another tip: There are plenty of clinical trials—many happening at Penn—to discover new treatment and diagnostic tools. Talk to your physician about whether a clinical trial is right for you.

Download our free cardiac arrhythmia guides: Ventricular Tachycardia Guide or Atrial Fibrillation Guide

About this Blog

The Penn Heart and Vascular blog provides the latest information on heart disease prevention, nutrition and breakthroughs in cardiovascular care.


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