Atrial fibrillation (AFib) with rapid ventricular response is a heart rhythm disturbance that puts you at higher risk for stroke and other serious complications. There are treatment options.
Atrial fibrillation (AFib) is a heart rhythm problem involving your heart’s upper chambers (atria). Heart failure and stroke are among the more serious possible complications of AFib. The complication risks are even greater when AFib is coupled with rapid ventricular response (RVR), an abnormal rhythm originating in the lower chambers (ventricles).
Several tests, including an electrocardiogram (ECG), can help doctors diagnose AFib with RVR. If treatment is necessary, a combination of heart medications may be enough to manage symptoms and reduce complication risks. Heart-related procedures may also be necessary.
Read on for more information about the symptoms, diagnosis, and treatment of AFib with RVR.
AFib occurs when the atria no longer beat in a steady rhythm synchronized to the beating of the ventricles. Instead, the atria beat chaotically and unpredictably. This means blood flow through your heart’s chambers is not as efficient as it should be.
As a result, blood can pool in the atria and form a clot. If that blood clot then travels to your brain, it can cause an ischemic stroke.
Inadequately regulated heart rates in AFib with RVR can cause a certain type of heart failure called tachycardia-induced cardiomyopathy and cause or worsen heart failure symptoms in those with some types of valvular heart disease and underlying heart dysfunction.
In AFib with RVR, the ventricles also beat unusually fast and chaotically. If you have AFib with RVR, your resting heart rate is likely to be more than 100 beats per minute. The risks associated with AFib with RVR include stroke, heart failure, and cardiomyopathy.
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If you have AFib with or without RVR, you may not know you have an abnormal heart rhythm. But if symptoms occur, they can include:
- chest pain
- dizziness or lightheadedness
- fatigue
- heart palpitations (the feeling that your heart is skipping a beat)
- shortness of breath
If you experience symptoms such as a racing heart or palpitations, you should discuss them with a healthcare professional. Even if you’re not sure you’re experiencing a change in your heart rate or rhythm, it’s best to have a healthcare professional examine you so that they can either make a diagnosis or rule out any serious problems.
To diagnose AFib with RVR, a doctor will usually begin by listening to your heart with a stethoscope. If they suspect a heart rhythm problem, they will order an ECG, which assesses the electrical activity in your heart and measures the speed and nature of your heartbeats. An ECG can usually detect an abnormal rhythm.
Other tests healthcare professionals may use to help with diagnosis include:
- blood tests to check potassium and thyroid hormone levels
- cardiac computed tomography (CT)
- echocardiogram
- magnetic resonance imaging (MRI)
Medications
If your doctor determines that treatment is necessary, they will likely prescribe one or more medications meant to stabilize your heart rate. These are the most commonly prescribed medications:
- Antiarrhythmics: Antiarrhythmics work either by interfering with additional or abnormal electrical impulses in your heart or by preventing abnormally fast impulses from moving throughout your heart. Examples include:
- flecainide
- propafenone
- sotalol
- dofetilide
- amiodarone (Pacerone, Cordarone)
- Beta-blockers: Beta-blockers, such as metoprolol (Lopressor, ToprolXL), block the effects of the hormone epinephrine (known commonly as adrenaline) to slow down certain cellular activity in your heart and help ease your heart’s workload.
- Calcium channel blockers: Calcium channel blockers, such as diltiazem (Diltzac, Cardizem), slow your heart rate and widen your blood vessels, which lowers your blood pressure. Because calcium causes your heart and arteries to constrict with greater pressure, calcium channel blockers are often effective at lowering blood pressure.
- Anticoagulant medication: If you have AFib with or without RVR, your doctor may prescribe an anticoagulant to reduce the risk of blood clot formation.
Cardiac procedures
The following heart-related procedures are also possible treatment options:
- Cardiac ablation: Cardiac ablation involves using radiofrequency energy or extreme cold (cryoablation) to destroy a small section of the heart tissue suspected of triggering the abnormal electrical activity.
- Pacemaker: In some cases, your doctor may choose to fit you with a pacemaker to help your heart keep a steady rhythm.
- Cardioversion: Cardioversion involves using short electrical shocks or charges to help restore a steadier heart rhythm. It can be effective, but AFib may return afterward.
It is possible to manage AFib with RVR with treatment and a heart-healthy lifestyle. Heart-healthy behaviors that
- eating a diet that supports weight management, blood pressure management, and blood sugar regulation
- limiting alcohol consumption
- avoiding or quitting smoking
- exercising regularly
- taking steps to manage blood pressure, blood sugar, and cholesterol levels
- making efforts to reach or maintain a moderate weight, if applicable
Is there a cure for AFib with RVR?
It’s often possible to manage the symptoms, but there is no official “cure” for AFib with RVR. If you have this condition, you may need to take medications for the rest of your life or receive other treatments, such as a pacemaker or cardiac ablation.
How long does it take for AFib medications to work?
If a healthcare professional gives you intravenous (IV) antiarrhythmics, beta-blockers, or calcium channel blockers, your heart may start to respond and settle into a safer rhythm within minutes. But the effects are usually temporary.
This means that you and your doctor will have to work out a treatment plan that includes oral medications you can take at home.
Can AFib with RVR be prevented?
It’s not always possible to prevent or avoid a heart rhythm problem, and it’s not always clear why one develops. Some of the risk factors, such as age and genetics, are not things you can change. But you may be able to manage some of the others, such as:
- weight
- blood pressure
- cholesterol levels
- sleep apnea
Activities that promote cardiovascular health can also help lower your risk of developing AFib with RVR.
AFib with RVR can be life threatening, but with timely and effective care, it’s possible to manage this heart condition. The key is to work closely with your healthcare team to consider treatment options such as medications, procedures, and a heart-healthy lifestyle.
AFib with RVR is a lifetime concern, but it does not need to interfere with most of your everyday activities.