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What can a doctor do if the cardiac meds are not working?

A MyHeartDiseaseTeam Member asked a question 💭
Tempe, AZ

I have CHF, chronic persistent afib with RVR, RBBB, a rare genetic disorder called Danon Disease, SVT, PWS, HCM. I've had 2 ablations, 6 cardio versions, on my 2nd pacemaker, and had a heart attack in 2025. The only thing left would be a heart transplant. All the meds I've tried either makes my heart race more or it had no effect. I've been through 4cardiologist and that have literally all passed me on to someone else. I'm on metaprolol and xarelto atm. But the metaprolol just lowers my blood… read more

August 7
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MyHeartDiseaseTeam

What options exist when cardiac medications aren't working for someone with a complex heart history like yours?

First, it's clear how much you've already been through — multiple ablations, cardioversions, pacemakers, and a heart attack. That's an enormous amount to carry, and feeling lost when even your doctors are Show Full Answer

What options exist when cardiac medications aren't working for someone with a complex heart history like yours?

First, it's clear how much you've already been through — multiple ablations, cardioversions, pacemakers, and a heart attack. That's an enormous amount to carry, and feeling lost when even your doctors are struggling is completely understandable. Given the complexity of your situation, a few avenues may still be worth exploring with a specialist:

- AV Node Ablation with pacemaker optimization — Since you already have a pacemaker, an AV node ablation could help control the rapid heart rate from AFib by letting the pacemaker fully manage your rhythm instead
- Left Atrial Appendage Occlusion (LAAO) — Since you're on Xarelto for clot prevention, this procedure closes the area where clots typically form, which could potentially reduce stroke risk
- ICD (Implantable Cardioverter-Defibrillator) — If not already in place, this device monitors and treats dangerous rhythms automatically
- Heart transplant evaluation — You mentioned this yourself, and given your history, it may genuinely be the most appropriate next conversation to have The most important step right now would be seeking care at a major academic medical center or specialized heart failure/transplant center. These centers have multidisciplinary teams experienced with rare and complex cases like yours, and they're less likely to simply pass you along.

A MyHeartDiseaseTeam member shared after their ablation: *"I'm drug-free, and I haven't had a single AFib event since."* Everyone's journey is different, but stories like that show that breakthroughs can still happen.

Please don't give up — your case deserves a team that specializes in exactly this level of complexity.

August 7
A MyHeartDiseaseTeam Member

I currently don't have a cardiologist. I'm in the mesa az area.

August 10
A MyHeartDiseaseTeam Member

@A MyHeartDiseaseTeam Member, I know that feeling only too well, being passed off and the doctors being afraid to treat you. I had so many of the same problems. I don't have the same congenital issue, but I understand; I have WPW syndrome. I finally found a group of doctors to help; they are adult cardiac specialists here in Atlanta at Emory Hospital. Search and see if you can find an Adult Congenital Cardiologist near you. If not, let me know, and I will see if my doctor has any connections that could help you in your area. To reach me directly @A MyHeartDiseaseTeam Member and I will be sure to see your message.

August 10

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