Atrial Fibrillation With Rapid Ventricular Response (Afib with RVR)

Atrial Fibrillation With Rapid Ventricular Response ( Afib with RVR) or cardiac rvr is a condition where atrial fibrillation is described as rapid ventricular response if ventricular rate is more than 100 bpm. [jpg]

What is Atrial Fibrillation (AFib) :

Atrial Fibrillation is the most common sustained cardiac arrhythmia. SA node or Sinoatrial node is the dominant pacemaker in a healthy normal heart. When the normal atrial electrical impulses are overwhelmed by disorganized electrical impulses in the atria resulting in irregular rhythm, absence of p waves or fibrillatory waves.

Atrial Fibrillation Pathophysiology:

SA node or Sinoatrial node is the dominant pacemaker in a healthy normal heart. This structure lies at the junction of the superior vena cava and the right atrium. It works as an electrical impulse generator. The impulse travels down the atria and makes the right and left atria to contract.  Thus they pump blood to the ventricles. The electrical impulse also travel from the atria to the ventricles through the atrioventricular (AV) node. The optimal function of the heart is the resultant of the synchronized electrical activity between the atria and the ventricles. When there is a structural change in the atria, SA node or AV node and abnormal triggering of impulses occur, the electrical activity of the atria becomes uncoordinated. This chaotic, irregular atrial compressions ultimately results in Atrial Fibrillation. In recent studies, the pathogenesis of Atial Fibrillation is thought to involve an interaction between initiating triggers  the form of rapidly firing ectopic foci located inside one or more pulmonary veins, and an abnormal atrial tissue substrate capable of maintaining the arrhythmia. Although structural heart disease underlies many cases of AF, the pathogenesis of AF in apparently normal hearts is less well understood. Although there is considerable overlap, pulmonary vein triggers may play a dominant role in younger patients with relatively normal hearts and short paroxysms of AF.  Abnormal atrial tissue  may play important role in a patient with structural heart disease and persistent or permanent AF.


Atrial Fibrillation Causes:

  • Hypertension both pulmonary or systemic
  • Atherosclerosis
  • Coronary Artery Disease
  • Cardiomyopathy
  • Valvular Heart disease
  • Congenital heart disease
  • Hyperthyroidism
  • Pulmonary embolism
  • Chronic obstructive pulmonary disease (COPD)
  • Pericarditis
  • Pneumonia
  • Asthma
  • Pheochromocytoma
  • Bronchogenic carcinoma
  • Carbon monoxide poisoning etc
  • Sleep Apnnea
  • Diabetes
  • Alcohol
  • Caffein
  • Amyloidosis

Common Symptoms:

  • Palpitations
  • Chest discomfort
  • Respiratory distress
  • Hypotension
  • Light-headedness
  • Loss of consciousness
  • Peripheral edema
  • Jugular vein distention
  • Pulmonary edema

Read about Coarse vfib

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