Even with treatment, some irregular heart rhythms return. Recurrent arrhythmias may require a more aggressive approach to treatment, as well as an acceptance of living with an arrhythmia.

An arrhythmia is a disruption to the electrical system that normally keeps your heart’s upper chambers (atria) and lower chambers (ventricles) beating in a steady, coordinated rhythm. It can cause your heart to beat too quickly, too slowly, or in a chaotic, inefficient manner.

Repeated episodes of heart rhythm disturbances are called “recurrent arrhythmia.” They present some treatment challenges and a greater risk of complications.

But, by working closely with a cardiologist and making heart-healthy lifestyle adjustments, you may be able to enjoy a long, healthy life, despite ongoing episodes of heart rhythm disruptions.

Any type of arrhythmia, including recurrent arrhythmia, means your heart isn’t pumping as effectively and efficiently as it should. This in turn can lead to some serious problems.

Certain arrhythmias can cause your heart to work too hard, potentially weakening the heart muscle. Other types of arrhythmia can lead to poor circulation to other organs and tissue, placing their health and function in jeopardy.

Atrial fibrillation (AFib)

The most common arrhythmia is atrial fibrillation (AFib). When a heart is in AFib, the atria beat in a rapid but chaotic manner, making the flow of blood through your heart less efficient.

A 2021 study suggests that about two-thirds of people with AFib experience recurrence of symptoms within a year after treatment including catheter ablation and/or antiarrhythmic medications. The majority of those individuals see a return of their AFib within 3 months.

Paroxsymal arrhythmias

Certain arrhythmias come and go on their own without treatment. These are known as paroxysmal arrhythmias, and they’re often relatively harmless.

Persistent arrhythmias

Other types of rhythm problems, called persistent arrhythmias, require treatment in order for symptoms to stop. A third kind of arrhythmia is classified as “permanent” when no treatments are effective in restoring a healthy rhythm.

Single event arrhythmia

It’s possible to have just one heart arrhythmia episode. Excessive alcohol use, for example, can cause a single event. A diagnosis of recurrent arrhythmia can be made when the heart experiences at least two episodes of rhythm disturbances.

An arrhythmia may return even if treatment appears successful at first. In many cases, treatments are simply able to restore a healthy rhythm for a limited amount of time.

For example, a 2022 study of people with AFib found that, for nearly half of the study participants who had catheter ablation, normal heart rhythms only lasted up to 2 years.

A separate study found that about one-third of participants who underwent electrical cardioversion for AFib required further treatments.

A 2018 study suggested that a common cause of recurrent AFib was the spontaneous reconnection of the pulmonary vein after that blood vessel was ablated as part of the initial AFib treatment. The research also suggested that subsequent ablations may be necessary, and that these additional treatments can lead to positive long-term outcomes.

Read more about cardiac ablations here.

Arrhythmia risk factors

It’s not always clear why someone experiences recurrent arrhythmia. But, the factors that predispose someone to developing an arrhythmia initially are the same as the factors that can raise the risk of arrhythmia recurrence. These include:

A 2020 study also notes that while people assigned male at birth (AMAB) are more likely than people assigned female at birth (AFAB) to develop an arrhythmia, AFAB people face a higher risk of recurrent arrhythmia after multiple ablation procedures.

Some recurrent arrhythmias are so mild, you may not notice any symptoms. In these cases, treatment may not be required. When symptoms are noticeable, they can include:

When to seek medical help

If you start to experience severe chest pain, pressure in your chest, or shortness of breath, especially at rest, call 911 or local emergency services — these could be symptoms of a heart attack or other medical emergency. If other symptoms develop, see or call a doctor or visit a walk-in medical clinic.

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Recurrent arrhythmia can lead to a number of potentially serious health complications. This is because a heart that’s not beating in a healthy rhythm can become overworked, and blood flow throughout the body can suffer.

Some of the more common complications of recurrent arrhythmia include:

The type and severity of an arrhythmia largely dictates the treatment or combination of treatments your doctor will recommend. The main treatments for recurrent arrhythmia include:

  • Antiarrhythmic medications: These drugs help slow down or speed up your heart to return it to a normal rhythm.
  • Cardioversion: This treatment method applies electrical energy from outside your chest to restore a normal rhythm.
  • Cardiac ablation: This treatment uses a catheter, inserted into a blood vessel (often in your upper leg) and guided to your heart, to emit radiofrequency energy or cold energy (cryoablation) to destroy a small portion of tissue suspected of causing the electrical disturbance.
  • Implantable devices: Doctors can put these devices — such as implantable cardioverter defibrillators and pacemakers — into your chest to help regulate irregular heart rhythms.

Lifestyle changes are also necessary to maintain healthy heart function. Some recommended changes include:

  • a heart-healthy diet, such as the Mediterranean or DASH diets
  • limited alcohol consumption
  • avoiding smoking
  • regular exercise
  • stress management

The outlook for someone with recurrent arrhythmia depends on the nature of the heart rhythm problem. Living with AFib, for example, means you have a higher risk of stroke. But, AFib is a much more manageable arrhythmia than others.

Ventricular fibrillation is the most dangerous arrhythmia. It represents a medical emergency, and can be life threatening if not treated within minutes of symptom onset.

Once you’ve receive a diagnosis of arrhythmia, understand that it’s a chronic condition that will have to be monitored and managed for the rest of your life. This may mean taking medications every day, watching what you eat, and exercising as advised by your medical care team.

Even if treatment is successful, there’s a chance the rhythm problem can return. Following the advice of your cardiologist or electrophysiologist (a cardiologist who specializes in arrhythmias) will give you the best odd of a healthy outcome.