AFib with RVR: Understanding Symptoms, Causes, and Treatment Options

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 (Also called Atrial Fibrillation with Rapid Ventricular Rate):

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. However, the pulse comes from the ventricles which can easily go as rapid as 100-200 beats per minute during AFib with RVR.

Symptoms of AFib with RVR

AFib with RVR can present with various symptoms, including:

– Heart palpitations or a sensation of a racing, irregular heartbeat

– Chest pain or discomfort

– Shortness of breath

– Dizziness or lightheadedness

– Fatigue or weakness

– Fainting (syncope)

Causes of AFib with RVR

Several risk factors may contribute to the development of AFib with RVR, such as:

– Underlying heart disease or structural abnormalities

– High blood pressure (hypertension)

– Coronary artery disease

– Heart valve disorders

– Hyperthyroidism

– Alcohol or drug abuse

– Certain medications, including stimulants or medications that affect heart rate

Did you know that there are many different types of atrial fibrillation (AFib)?

How To Diagnose AFib with RVR

Diagnosing AFib with RVR involves a multi-step process that begins with an in-depth patient history and physical examination, which can help identify potential symptoms such as heart palpitations, dizziness, or shortness of breath. Healthcare providers often utilize various diagnostic tools and procedures to confirm the diagnosis:

1. Electrocardiogram (ECG or EKG): This is often the first-line diagnostic tool, as it records the electrical activity of the heart and can show if the heart rhythm is irregular or faster than normal.

2. Holter Monitor: This portable ECG device is worn by the patient for a day or more to provide a continuous 24-hour record of the heart’s rhythm.

3. Event Recorder: Similar to a Holter monitor, an event recorder is worn for longer periods and the patient activates it when they experience symptoms. Event recorders can be worn for up to 4 weeks if needed.

4. Echocardiogram: This ultrasound examination of the heart can reveal structural heart diseases that may cause or contribute to AFib with RVR.

5. Blood Tests: These are used to rule out thyroid problems, electrolyte abnormalities, or other abnormalities in the blood that may lead to AFib with RVR.

Based on the results from these diagnostic tests, doctors can then determine if a patient has AFib with RVR and propose a suitable treatment plan.

Treatment Options for AFib with RVR

The primary goals of treating AFib with RVR are to control the ventricular rate, restore normal heart rhythm, and prevent complications such as blood clots and stroke. Treatment options include:

Medications for AFib with RVR

– Rate control: Beta-blockers, calcium channel blockers, or digoxin may be prescribed to slow down the ventricular rate. These are the most common first line treatment options for AFib with RVR.

– Rhythm control: Antiarrhythmic medications, such as amiodarone or flecainide, can help restore normal heart rhythm.

– Anticoagulants: Blood thinners like warfarin or direct oral anticoagulants (DOACs: Such as Eliquis or Xarelto) can reduce the risk of blood clots and stroke.

Cardioversion

Electrical or pharmacological cardioversion may be used to restore normal heart rhythm in patients with AFib and RVR. This is especially useful for patients with unstable symptoms from AFib with RVR such as severe dizziness, shortness of breath, or chest pain.

Read more about cardioversion procedures here.

Catheter Ablation for AFib

Catheter ablation is a minimally invasive procedure that targets the areas of the heart responsible for triggering AFib. This treatment option may be recommended for patients who do not respond well to medications or cardioversion. In addition, a catheter ablation procedure can be an excellent option for patients with a history of multiple AFib with RVR episodes to get better long-term control over AFib.

Read more about a catheter ablation procedure here.

Lifestyle Modifications for AFib with RVR

In addition to the above treatments, lifestyle changes play a crucial role in managing AFib with RVR and reducing the frequency and severity of symptoms. These include:

1. Heart-Healthy Diet: Following a diet low in saturated fats, trans fats, and cholesterol, and high in fiber can help manage heart disease.

2. Regular Exercise: Physical activity can help maintain a healthy weight and lower blood pressure, reducing the burden on the heart.

3. Avoiding Alcohol and Caffeine: These substances can trigger an episode of Afib with RVR in some people.

4. Quitting Smoking: Smoking damages the heart’s structure and function and smoking cessation can improve heart health and reduce frequency of AFib.

5. Managing Stress: Chronic stress can contribute to heart rhythm problems, so techniques such as yoga, meditation, and deep breathing can help manage AFib with RVR.

Frequently Asked Questions About AFib with RVR

What is the Difference Between AFib and AFib with RVR?

AFib is an irregular and often rapid heartbeat caused by the atria quivering or fibrillating. AFib with RVR refers to a rapid ventricular rate that occurs when the irregular electrical signals from the atria are transmitted to the ventricles at a faster-than-normal rate, leading to compromised heart function.

What is the First-Line Treatment for AFib with RVR?

The first-line treatment for AFib with RVR typically involves medications to control the ventricular rate, such as beta-blockers, calcium channel blockers, or digoxin. Additional treatments, such as rhythm control medications, anticoagulants, cardioversion, or catheter ablation, may also be recommended depending

What Are Complications of AFib with RVR

Just 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.

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.

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

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.

Can AFib with RVR be Prevented?

While you cannot always prevent AFib with RVR, you can reduce your risk. This includes maintaining a heart-healthy lifestyle: eating a balanced diet, exercising regularly, avoiding smoking and excessive alcohol, managing stress, and controlling other health conditions such as high blood pressure, high cholesterol, and diabetes. Regular check-ups with your healthcare provider are also essential, as early detection and management of heart conditions can significantly impact prognosis.

How To Reverse Atrial Fibrillation Naturally

If 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.

Learn More About The Take Control Over AFib Program Here

Putting It All Together

Overall, 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!