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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Atrial Fibrillation with Rapid Ventricular Rate (AF with RVR)
Introduction
Atrial fibrillation (AF) is a common heart rhythm disorder where the upper chambers of the heart (atria) beat irregularly and out of sync with the lower chambers (ventricles). When the ventricular rate becomes too fast (typically over 100 beats per minute), this is referred to as atrial fibrillation with rapid ventricular rate (AF with RVR). This condition can lead to serious complications, such as heart failure, ischemia, or stroke.
Causes and Risk Factors
Several factors can contribute to the development of AF with RVR: - Hypertension (high blood pressure) - Heart diseases (coronary artery disease, heart failure, valvular disease, myocarditis) - Hyperthyroidism or other metabolic disorders - Excessive alcohol, caffeine, or stimulant use - Lung diseases (chronic obstructive pulmonary disease, pulmonary embolism) - Previous heart surgeries or aging-related degeneration
Symptoms
- Palpitations (rapid, irregular heartbeat)
- Shortness of breath
- Dizziness or lightheadedness
- Chest pain or discomfort
- Fatigue and weakness
- Syncope (fainting), especially in severe cases
Diagnosis
Physicians diagnose AF with RVR using: - Electrocardiogram (ECG): Shows an irregular rhythm and absence of P waves. - Holter monitoring: Continuous ECG over 24-48 hours to detect intermittent AF. - Echocardiogram: Evaluates heart structure and function. - Blood tests: Check for underlying causes like thyroid disorders or electrolyte imbalances.
Treatment
Immediate Management (Acute Episodes)
- Control the ventricular rate: Medications like beta-blockers (metoprolol), calcium channel blockers (diltiazem, verapamil), and sometimes digoxin.
- Restore normal heart rhythm if necessary: Electrical cardioversion or antiarrhythmic drugs (amiodarone, flecainide) may be used.
- Anticoagulation to prevent stroke: If AF persists, blood thinners such as warfarin, apixaban, or rivaroxaban may be prescribed.
Long-Term Management
- Rate control vs. rhythm control: Some patients may need continuous medication to maintain normal heart rhythm, while others only need to control the heart rate.
- Lifestyle modification: Reducing alcohol, tobacco, and caffeine intake, managing stress, and treating underlying conditions.
- Ablation therapy: Catheter ablation may be considered in treatment-resistant cases.
Conclusion
AF with RVR is a potentially serious condition requiring swift diagnosis and management. Patients should work closely with their healthcare provider to optimize treatment and reduce stroke risk.
Source recommendations
1. American Heart Association (AHA) Guidelines for Atrial Fibrillation
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
- https://professional.heart.org/en/science-news/2023-acc-aha-accp-hrs-guideline-for-the-diagnosis-and-management-of-atrial-fibrillation
- https://www.heart.org/en/health-topics/atrial-fibrillation
- https://pubmed.ncbi.nlm.nih.gov/38033089/
- https://newsroom.heart.org/news/sweetened-drinks-linked-to-atrial-fibrillation-risk
2. European Society of Cardiology (ESC) Guidelines for the Diagnosis and Management of Atrial Fibrillation
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Atrial-Fibrillation
- https://academic.oup.com/eurheartj/article/42/5/373/5899003
- https://www.escardio.org/static-file/Escardio/Guidelines/Documents/ehaa612.pdf
- https://pubmed.ncbi.nlm.nih.gov/32860505/
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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