AFib is the most common arrhythmia, affecting an estimated 3 to 6 million people in the United States. About 1 in every 3 to 5 people is expected to develop AFib in their lifetime. This risk is expected to increase in the coming years as our population is aging and accumulating more risk factors.
This article will discuss symptoms, diagnosis, and management of AFib with RVR.
Meaning of RVR In Cardiology
The heart is made of four chambers: two upper chambers called the atria, and two lower chambers called the ventricles. Electrical signals in the atria cause the heart chambers to contract and beat to pump blood to the body. Heart rate is determined by the rate of ventricular contraction. In AFib, the atria rapidly beat due to erratic electrical signals. These signals are irregularly transmitted down to the ventricles and cause an irregular rapid ventricular heart rate (RVR).
Symptoms
AFib can be intermittent and it does not always cause symptoms, so some people may not know that they have Afib. Other people may experience symptoms ranging from mild to severe, including:
Fatigue Heart palpitations (feeling of a racing or irregular heartbeat) Exercise intolerance Lightheadedness or dizziness Shortness of breath Chest pain Fainting
Some symptoms of AFib can overlap with other serious and life-threatening conditions like a heart attack. If you are experiencing concerning symptoms, such as chest discomfort or difficulty breathing, seek medical attention immediately as these may be signs of a heart attack.
Risk Factors
AFib risk factors include:
High blood pressureIncreasing ageHeart failureObesityDiabetesKidney diseaseAlcohol useTobacco useHyperthyroidism (when the thyroid gland makes too many hormones)
What If You Have AFib Without RVR?
AFib does not necessarily cause a rapid heart rate. Some people with AFib may have a slow or normal heart rate. In this case, there may or may not be symptoms, but increased risk of stroke still needs to be evaluated and addressed with your healthcare provider.
How Serious Is AFib With RVR?
AFib is a serious condition that increases the risk of stroke regardless of whether or not RVR is present. However, having Afib with RVR is even more serious. With a rapid heart rate, the heart’s beating is inefficient and cardiac output can drop.
When this happens, the heart is not supplying blood adequately to the body, whcih cause lack of blood flow to organs and the brain, leading to fainting and congestive heart failure.
A chronically elevated heart rate can also lead to a type of heart failure called tachycardia-induced cardiomyopathy.
Diagnosis
AFib with RVR is diagnosed using an electrocardiogram (ECG). An ECG is a noninvasive test that picks up the heart’s rhythm using electrodes placed on the chest. ECG can be performed at a healthcare provider’s office or in a hospital.
However, an ECG is just a snapshot of the heart’s rhythm, and since AFib can come and go, a single ECG may not capture the abnormal rhythm. In this case, longer forms of monitoring are needed. A healthcare provider might order a patch monitor, a Holter monitor, or place an implantable loop recorder, which are all forms of ambulatory rhythm monitoring that can monitor the heart over longer periods of time.
Treatment
Treatment of AFib can involve staying out of AFib (rhythm control), or controlling the heart rate (rate control). Both approaches also require attention to reduce the risk of stroke.
Rhythm Control in AFib
AFib can come and go (paroxysmal AFib) or be constant (persistent or permanent AFib). When a cardiologist determines that the best course of action is to stay out of AFib with rhythym contro, whether because of symptoms or complications like heart failure, a rhythm control strategy can include the following:
Antiarrhythmic medications like Rythmol (propafenone) or Tambocor (flecainide) Electrical cardioversion Cardiac ablation
Heart Control in Afib With RVR
AFib with RVR can be a medical emergency, and in this case, electrical cardioversion and intravenous medications can be given to rapidly control heart rate and rhythm.
In a non-emergency setting, staying in AFib while managing heart rates may be appropriate. In this case, oral medications to keep the heart rate in an acceptable range can be prescribed, including:
Beta-blockers like Rythmol (propafenone) or Tambocor (flecainide) Calcium channel blockers, specifically non-dihydropyridine type, which includes Cardizem (diltiazem) or Calan
In some cases, antiarrhythmic medications that have a rate-slowing effect, such as amiodarone or digoxin may be used to help control heartrate.
Stroke Prevention in AFib
One serious complication of Afib is stroke. AFib is estimated to be the cause of 1 in 4 strokes in people over the age of 80. Stroke can be life-threatening and disabling, and increase the risk of dementia.
Stroke risk in AFib is higher when certain other conditions are present, like diabetes, heart failure, hypertension, increased age, and vascular disease. Your healthcare provider can discuss your risk of stroke and make recommendations on a treatment plan that includes taking a blood thinner to help lower your risk.
Living Well With AFib With RVR
AFib with RVR can cause a range of symptoms, but there are many treatment options available. Some people may only require controlling heart rate for symptom management. Or you may need a rhythm control strategy to help keep heart rhythm normal and allow you to continue exercise and activities without limitations.
Controlling other heart disease and AFib risk factors is also beneficial and includes:
Eating a healthy diet Controlling blood pressure, cholesterol, and blood sugar Maintaining a healthy weight Getting regular physical exercise Treating any sleep-disordered breathing Reducing alcohol intake
Summary
AFib with RVR is a serious condition that can cause various symptoms and increase the risk of stroke and heart failure. While many people have undiagnosed AFib, it can be easily diagnosed with noninvasive heart rhythm monitoring. Treatment includes controlling heart rate, making certain lifestyle changes, and taking medication.
