Afib with RVR: What You Need to Know
A heart arrhythmia is an abnormal rate or rhythm in your heartbeat. This can mean your heartbeat is too slow, too fast, or has an irregular rhythm. Most of these are harmless, and may not even cause symptoms, but some types of arrhythmias can have serious consequences and require treatment.
Dangerous arrhythmias may cause heart failure, stroke, or low blood flow that results in organ damage. Most people with arrhythmias, even serious ones with treatment, live normal and healthy lives.
Atrial fibrillation, or AFib, is the most common type of arrhythmias. Approximately four percent of the U.S. population has either intermittent or permanent Afib. In people over the age of 60, the incidence rises to about nine percent.
AFib is caused by abnormal electrical impulses in the atria, which are the upper chambers of the heart. The result is a rapid and irregular pumping of blood through the atria. These chambers fibrillate, or quiver, rapidly. AFib may or may not produce symptoms or cause serious complications.
Rapid Ventricular Rate or Response
In some cases of AFib, the fibrillation of the atria causes the ventricles, the 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 will experience symptoms, typically a rapid or fluttering heartbeat. RVR can be detected and confirmed by your doctor. It can cause serious complications and requires treatment.
The Dangers of RVR
When the ventricles beat too rapidly they do not fill completely with blood from the atria. As a result, they cannot efficiently pump blood out to meet the needs of the body. Ultimately this can lead to heart failure.
Heart failure as a result of AFib with RVR is most common in patients who already have another type of heart disease. RVR can cause chest pains and make conditions like congestive heart failure worse.
AFib Without RVR
It is possible to have AFib without RVR. If you have AFib, but a normal ventricular response, you may not experience any symptoms at all, and you will likely not feel an irregular or rapid heartbeat. 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 (ECG). This is a diagnostic tool that records the electrical activity of your heart. AFib and RVR create distinctive patterns of waves on an ECG that doctors can use to confirm the presence of the arrhythmia.
An ECG 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.
Treatment for AFib
Some people with AFib do not need treatment. But the presence of RVR or other health conditions make the arrhythmia more serious. In these instances treatment is needed.
There are three goals of treating AFib with RVR. The first is to control the RVR. The next is to reduce the risk of blood clots forming in the atria, which can cause a stroke. Finally, treatment includes attempting to restore the overall rhythm of the heart back to normal.
Controlling RVR with Medications
If you have RVR, controlling the ventricular rate will be the first goal of treatment. RVR is the main cause of complications from AFib, so it is important to get it under control quickly. Medications are usually the first step. Beta blockers, calcium channel blockers, and digoxin are all used to slow the ventricular rate in patients with this condition.
Using a Pacemaker
In some patients, the medications may fail to restore a normal ventricular rate. In this instance, a more invasive treatment plan may be needed. An artificial pacemaker, which is an electronic device that regulates the beating of the heart, can be installed.
For most people with AFib, even with RVR, a normal lifestyle is possible. The greatest risk is the possibility of stroke, but by making healthy lifestyle choices and following doctor’s instructions, the risk can be decreased.
Treatments for AFib with RVR are usually successful, but the condition often returns. Exactly what the prognosis will be depends on each individual situation.
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