Atrial fibrillation is the most common cause of irregular heartbeat in adults. AFib is caused by abnormal electrical impulses in a part of the heart known as the atria. In time, it can lead to heart failure. Show
What is AFib? Atrial fibrillation, or AFib, is the most common type of arrhythmia in adults. A heart arrhythmia is when your heartbeat has an abnormal rate or rhythm. This can mean it beats too slowly, too quickly, or irregularly. Arrhythmias are often harmless and may not cause symptoms or complications. However, some types can have serious consequences and require treatment. Dangerous arrhythmias may lead to heart failure, heart attack, stroke, or low blood flow that results in organ damage. Most people with arrhythmias, even the ones that require treatment, live normal and healthy lives. Approximately 2 percent of Americans under the age of 65 have either intermittent or permanent AFib. In people over the age of 65, the incidence rises to about 9 percent. AFib is caused by abnormal electrical impulses in the atria, which are the upper chambers of the heart. These chambers fibrillate, or quiver, rapidly. The result is a rapid and irregular pumping of blood through the heart. In some cases of AFib, the fibrillation of the atria causes the ventricles, or lower chambers of the heart, to beat too fast. This is called a rapid ventricular rate or response (RVR). If you have AFib with RVR you’ll experience symptoms, typically a rapid or fluttering heartbeat. You can also experience chest pain, shortness of breath, dizziness, or passing out. RVR can be detected and confirmed by your doctor. It can cause serious complications and requires treatment. When the ventricles beat too rapidly they don’t fill completely with blood from the atria. As a result, they can’t efficiently pump blood out to meet the needs of the body. This can ultimately lead to heart failure. Heart failure as a result of AFib with RVR is most common in those who already have another type of heart disease. RVR can cause chest pain and make conditions such as congestive heart failure worse.
It’s possible to have AFib without RVR. If you have AFib, but a normal ventricular response, you may not experience any symptoms. Some symptoms are possible if you have AFib without RVR. These can include shortness of breath, dizziness, fatigue, or instances of excessive sweating. The only way to definitively diagnose AFib, as well as RVR, is to get an electrocardiogram (EKG). This is a diagnostic tool that records the electrical activity of your heart. AFib and RVR create distinctive patterns of electrical waves on an EKG that doctors can use to confirm the presence of the arrhythmia. An EKG can be performed in a doctor’s office, but a 24-hour recording of the heart can also be made using a Holter monitor. This gives a more complete picture of what the heart is doing. Heart monitors may be worn for more extended periods as well. Learn more: 24-hour Holter monitoring » Some people with AFib don’t need treatment for their arrhythmia. But the presence of RVR or other health conditions makes the arrhythmia more serious. In these instances, treatment is necessary. There are three goals of treating AFib with RVR:
Medications are typically the first step toward controlling the ventricular rate. Some common medications used to slow the ventricular rate in people with this condition include:
For some people, medications may fail to restore a normal ventricular rate. In this case, an artificial pacemaker can be installed. This electronic device regulates the beating of the heart. Another option can also include ablation. This is a procedure done by a specialist that eliminates the abnormal electrical pathway that’s causing the arrhythmia. A normal lifestyle is possible for most people with AFib, even those with RVR. Controlling the heart rate is necessary to maintain good blood and oxygen flow to the heart, brain, and body. Treatments for AFib with RVR are usually successful, but the condition can return. Talk to your doctor to learn more about the prognosis for your specific condition. Did you know that there are many different types of atrial fibrillation (AFib)? While many symptoms of atrial fibrillation are similar, specific types can cause additional risks and require additional monitoring and management. Correct identification of your atrial fibrillation is essential for getting the proper treatment and care you need. As an electrophysiologist, I work with AFib patients everyday to properly diagnose their specific subtype of atrial fibrillation, and create a personalized treatment plan. Here is everything you need to know about AFib with RVR: What is AFib with RVR?AFib with RVR is a subtype of the overall condition of atrial fibrillation. RVR stands for rapid ventricular rate, which is defined as a heart rate of over 100 beats per minute. To better understand this condition, we first need to understand the basic anatomy of the human heart. The heart has four chambers — two upper atriums and two lower ventricles. In patients with atrial fibrillation, the atrium is beating so fast that it is basically quivering. The atrium rate can get up to 600 beats per minute. What is the Difference Between AFib and AFib with RVR?Fortunately, in AFib the overall pulse does not go as fast as the atria do, but they can still become very rapid with heart rates from 100 -200 beats per minute. That is what happens during AFib with RVR, the overall pulse rate is very rapid, over 100 beats per minute. On the other hand, AFib with controlled ventricular rate is defined as AFib where the overall pulse is not rapid, usually betweem 60-100 beats per minute. What are the Causes of AFib with RVR?There are several known common risk factors for atrial fibrillation. The common risk factors for atrial fibrillation are the same as risk factors for AFib with RVR. Some of the most common risk factors for atrial fibrillation include: ● Having uncontrolled high blood pressure ● Having an elevated body mass index (BMI) ● A history of heart disease (having a past history of a heart attack or congestive heart failure, for example) ● Family history of atrial fibrillation ● Advanced age (the incidence of new atrial fibrillation significantly increases after 60 years of age) ● Living with other chronic health conditions, such as sleep apnea, diabetes, lung disease, or thyroid conditions ● Alcohol abuse Symptoms for AFib with RVRBecause AFib with RVR is a type of atrial fibrillation, the symptoms are very similar. That being said, one big difference is the resting heart rate between these two conditions. People with AFib with RVR experience an elevated heart rate, leading to the feeling of your heart pounding in your chest and increased anxiety. Common symptoms of AFib with RVR include: ● Heart palpitations, fluttering, or the feeling of it pounding in your chest ● Fatigue ● Chest tightness and pain ● Shortness of breath ● Confusion ● Dizziness and lightheadedness ● Overall weakness Complications of AFib with RVRJust like any type of atrial fibrillation, patients with AFib with RVR are at risk of developing serious complications. Some of the most common complications include: ● Blood clots — When blood cannot properly circulate from the heart’s atriums, blood clots can form. These clots can result in serious medical emergencies, such as pulmonary embolisms, heart attacks, and strokes. ● Heart failure — Heart failure occurs when the heart muscle has been damaged. Uncontrolled atrial fibrillation can wear down the heart muscle, resulting in overall poor heart function and heart failure. This is an elevated risk for people with AFib with RVR, as the entire heart is working harder to beat at the elevated rate. ● Stroke — People with AFib are at a significantly elevated risk of developing a stroke. A stroke is a serious medical condition caused by a blood clot becoming lodged in the vessels of the brain. Use the helpful acronym F.A.S.T to identify the common symptoms of a stroke: Face Drooping: Is one side of their face drooping? Arm Weakness: Are they experiencing one-sided weakness of an arm or leg? Speech Difficulty: Is their speech slurred or difficult to understand? Time to Call 911: If someone shows any of these symptoms, even if the symptoms go away, call 911 and get them to the hospital immediately. Treatment for AFib with RVRThere are many different treatment options for AFib with RVR. The treatment option best suited for you will be dependent on your symptoms, health history, and lifestyle. The most common treatment for AFib with RVR is the use of rate-controlling medications. These can be taken orally at home or used during an emergency situation in the hospital. In an emergency room, a patient will likely receive intravenous medications for rapid control of the heart rate. Some of the most commonly used medications include: ● Metoprolol ● Diltiazem ● Digoxin ● Amiodarone When medical therapy cannot resolve an episode of AFib with RVR, the next option may be a procedure. The most common first procedure performed in a hospital setting is a cardioversion. A cardioversion is an electrical shock used to return the heart to a normal rhythm. Read more about cardioversion procedures here. Finally, in patients with long-term unresolved AFib with RVR, an invasive procedure may be required. A catheter ablation procedure is a common treatment option to reduce episodes of AFib with RVR. Read more about ablation procedures here. Frequently Asked Questions About AFib with RVR:Is AFib with RVR Life-Threatening?The most dangerous part about AFib with RVR is not necessarily the heart rate — it is actually the symptoms that patients may feel. I've had patients who have had elevated heart rates of 120 or 130 bpm for weeks at a time — and the crazy thing is, they are fairly asymptomatic. However, many people feel their episodes of atrial fibrillation very differently. Some patients experience severe symptoms during episodes of atrial fibrillation. Symptoms like shortness of breath, feeling dizzy or light-headed, or having chest pain are examples of AFib symptoms that require medical attention. However, the most significant danger of any type of atrial fibrillation is an increased risk for stroke. Learn more about the risk of stroke for AFib patients here. Can Stress Cause AFib with RVR?Stress can trigger episodes of AFib, including AFib with RVR. Some common sources of stress include: ● Poor work-life balance ● Lack of sleep ● Increased alcohol use ● Eating unhealthy foods ● Having elevated levels of stress hormones What is the Heart Rate for AFib with RVR?To be diagnosed with AFib with RVR, a patient needs to have a resting heart rate of over 100 beats per minute. That being said, I have frequently seen heart rates of close to 200 beats per minute in patients with AFib with RVR. When the heart rate of AFib is between 60-100 beats per minute, it is defined as controlled ventricular rate or CVR. What are Some Triggers of AFib with RVR?While every case of AFib is different, some common triggers increase your likelihood of experiencing an episode of AFib. Common triggers include: ● Sleep deprivation ● Increased alcohol consumption ● Illness ● Increased stress ● Hormonal changes ● Strenuous exercise ● Caffeine How Can You Stop AFib with RVR at Home?There are a few at home methods that can may be able to stop an episode of AFib with RVR, and ultimately avoid a visit to an emergency room. Some methods include: ● Vagal Manuevers ● Meditation ● Yoga ● Exercise ● Taking Additional Medications (always discuss with your doctor if taking extra medications is safe for you) To read more about stopping an AFib episode at home, read my article here. How To Reverse Atrial Fibrillation NaturallyIf you are interested in natural treatment options for atrial fibrillation and are highly motivated in improving your symptoms naturally, to reduce your need for medications or even procedures, then take a look at my one-of-a-kind, online educational program,Take Control Over AFib. Lifestyle modifications and reducing inflammation are essential components of the long-term management of atrial fibrillation. Addressing the source cause of atrial fibrillation can lead to a significant benefit for most AFib patients. Targeted lifestyle modifications can reduce your symptoms, reduce your reliance on medications or procedures, and even improve the long-term success rate of a catheter ablation procedure for AFib. However, most patients are not given instructions or tips on how to accomplish these essential lifestyle modifications in an AFib targeted style. This is exactly why I created the Take Control Over AFib Program, to give people a step-by-step plan to improve and potentially reverse atrial fibrillation naturally. Thinking about lifestyle modifications is easy, but putting in place a system to keep you committed to achieve real results takes time and dedication, and with my step-by-step plan, we can achieve powerful and long-lasting results together. The Take Control Over AFib Online Program is currently only available in English Language. Learn More About The Take Control Over AFib Program Here Putting It All TogetherOverall, AFib with RVR is treated very similarly to regular atrial fibrillation. That being said, it is essential to see your doctor if you notice any change to your heart rate, as you may require medical attention. As an electrophysiologist, I work with patients with a wide variety of heart arrhythmias. If you have any questions about atrial fibrillation, I would love to chat with you about it! Follow me on social media and ask me a question— I am looking forward to hearing from you! How do you treat atrial fibrillation with rapid ventricular response?Drugs called beta-blockers. They control your heart rate. Your doctor will get them to you in your vein (they'll call this intravenously) if you have AFib with RVR.. Esmolol (Brevibloc). Metoprolol (Lopressor, Toprol). Propranolol (Inderal, Innopran). What is the common medication used to treat atrial fibrillation with rapid ventricular response?The calcium channel blockers diltiazem (Cardizem) and verapamil (Calan, Isoptin) are effective for initial ventricular rate control in patients with atrial fibrillation. These agents are given intravenously in bolus doses until the ventricular rate becomes slower.
Is atrial fibrillation with rapid ventricular response serious?A-fib with RVR needs to be medically managed in order to reduce the risk of serious complications. While the condition is generally not fatal, it can increase the likelihood of a person developing many serious complications, including: new or worsening heart failure. stroke.
Can AFib with RVR be cured?Outlook. A normal lifestyle is possible for most people with AFib, even those with RVR. Controlling the heart rate is necessary to maintain good blood and oxygen flow to the heart, brain, and body. Treatments for AFib with RVR are usually successful, but the condition can return.
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Atrial fibrillation with rapid ventricular response treatment
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