Atrial Fibrillation With RVR

What is A-fib with RVR?

Atrial fibrillation with rapid ventricular rate (A-fib with RVR) is an abnormal heart rhythm. People with atrial fibrillation (A-fib) have disorganized electrical signals that make their upper heart chambers (atria) contract in an uncoordinated way. These signals travel down to the lower chambers (ventricles) and tell them to beat in an irregular way. People who have A-fib with RVR also have an issue in their lower heart chambers. They have a heart rate of 100 beats per minute or more.

When you have A-fib with RVR, it’s difficult for your heart to pump the amount of blood it should. That makes it hard for your body to get the oxygen-rich blood it needs to function.

How common is it?

Atrial fibrillation is the most common type of abnormal heart rhythm. Nearly 4 million emergency room visits from 2007 to 2014 in the United States were for atrial fibrillation. An estimated 2 million people in the U.S. have A-fib.

What are the symptoms?

A-fib with RVR symptoms include:

• Heart palpitations.
• Dizziness.
• Passing out.
• Chest pain.
• Shortness of breath.
• Anxiety.
• Fatigue.

Some people don’t have symptoms at all. For those who have symptoms, they may be mild or severe.

What causes A-fib with RVR?

Causes of A-fib with RVR include:

• Coronary artery disease.
• High blood pressure.
• Heart failure.
• Obstructive sleep apnea.
• Heart surgery. You can be at risk for A-fib with RVR days or weeks after your operation.

What are the risk factors?

You’re more likely to have A-fib with RVR if you:

• Are over age 50.
• Are white.
• Live in North America.
• Have a BMI higher than 30.
• Have obstructive sleep apnea.
• Drink alcohol.
• Consume a lot of caffeine.
• Have a close relative who’s had A-fib.

What are the complications?

A-fib with RVR can lead to:

• Less time for your ventricles to fill with blood.
• Heart muscle needing more oxygen.
• Cardiomyopathy.
• Stroke.
• Low blood pressure.
• Congestive heart failure.

How is A-fib with RVR diagnosed?

A healthcare provider will do a physical exam and ask about your medical history. They’ll also order tests.

What tests will be done to diagnose A-fib with RVR?

Tests to diagnose A-fib with RVR include:

• Electrocardiogram (EKG).
• Echocardiogram.
• Cardiac computed tomography (CT).
• Magnetic resonance imaging (MRI).
• Blood tests.

What is the treatment for A-fib with RVR?

A healthcare provider will work to manage your symptoms of A-fib with RVR and prevent complications from it. A-fib with RVR treatment includes:

• Electrolytes.
• Medicines.

Specific medicines/procedures used

A-fib with RVR medications may include:

• Beta-blockers like metoprolol (Lopressor® or Toprol®XL).
• Calcium channel blockers like diltiazem (Diltzac® or Cardizem®).
• Antiarrhythmics like amiodarone (Pacerone® or Cordarone®) or digoxin (Lanoxin® or Cardoxin®).

You’ll also need to take an anticoagulant to help prevent blood clots that could cause a stroke. If you can’t take anticoagulants long-term, you may be able to have a left atrial appendage closure to prevent blood clots.

Some people who have A-fib with RVR will need more than medicine. They may need a procedure, such as:

• Catheter ablation.
• A pacemaker.
• Electrical cardioversion.
• Maze procedure.

Complications/side effects of the treatment

Side effects and complications vary depending on which treatment you receive. Complications from catheter ablation may include cardiac tamponade or a heart attack. Pacemakers can malfunction. Some people have skipped heartbeats or A-fib episodes for a few months after a maze procedure.

Medicines for A-fib with RVR treatment may cause:

• Headache.
• Low blood pressure.
• Dizziness.
• Upset stomach.

How soon after treatment will I feel better?

Your heart rate may slow down just minutes after you receive some of the above medicines through an IV.

How can I lower my risk of A-fib with RVR?

You can help lower your risk of A-fib with RVR with healthy habits. These include:

• Exercising for 150 minutes a week at a moderate pace.
• Eating foods that are good for your heart.
• Limiting how much alcohol you drink.
• Avoiding tobacco products.
• Managing other conditions, such as high blood pressure, high cholesterol, sleep apnea or diabetes.

What can I expect if I have A-fib with RVR?

Starting healthier habits, taking medications and having procedures can help you manage A-fib with RVR. Without treatment, A-fib with RVR can lead to heart disease, heart failure or a stroke. Catheter ablation provides an effective, minimally invasive treatment of atrial fibrillation. The maze procedure has a success rate of 80% to 90%, and provides long-term freedom from symptoms.

How long it lasts

A-fib with RVR can go on for years. Some people have more frequent and longer-lasting episodes as time goes on.

How do I take care of myself?

Be sure to take all medicines your healthcare provider prescribed. Going to all of your follow-up appointments is important, too. Getting regular exercise — like walking — can improve your quality of life and make it easier to do daily tasks.

When should I see my healthcare provider?

Contact your provider if you have:

• Chest pain.
• A heart rate higher than 100 when you’re at rest.
• Dizziness.
• Shortness of breath.

When should I go to the ER?

Get emergency treatment if you have:

• Stroke symptoms (sudden headache or difficulty with vision, speech or walking).
• Too much bleeding from a blood thinner (red vomit, poop or pee).
• Chest pain or other signs of a heart attack or cardiac arrest (shortness of breath or upset stomach).

What questions should I ask my doctor?

Questions you may want to ask your provider include:

• How often do I need follow-up appointments?
• How long will it take for lifestyle improvements to show results?
• Which medicine do you recommend and why?
• Should I undergo a procedure such as cardioversion, ablation or a maze procedure?

A note from Cleveland Clinic

The feeling of an unusual heartbeat is unsettling, but treatments are available to help you manage A-fib with RVR. Your healthcare provider can guide you in deciding which treatments are best for you. You can play an important role in your health by keeping your follow-up appointments and taking the medicines your provider prescribed.