What is RVR? 

RVR stands for a rapid ventricular response and it can be triggered by atrial fibrillation. A ventricular rate higher than 100 beats per minute is considered rapid ventricular response.
RVR stands for a rapid ventricular response and it can be triggered by atrial fibrillation. A ventricular rate higher than 100 beats per minute is considered rapid ventricular response.

Atrial fibrillation with a rapid ventricular response (RVR) occurs when rapid contractions of your atria cause the ventricles in your heart to beat too fast. This rapid beating means your ventricles aren’t receiving enough blood and can’t give your body correctly oxygenated blood. If this happens too often, it can lead to stroke or heart failure

RVR stands for a rapid ventricular response. RVR can be triggered by atrial fibrillation. Having uncontrolled and fast heartbeats can ultimately lead to advanced heart failure. There may be other causes of RVR, but atrial fibrillation is the most common. 

What is atrial fibrillation?

Atrial fibrillation occurs in the top chambers of your heart. In this condition, the atria twitch quickly or fibrillate and don’t fully contract. This makes the bottom sections of your heartbeat out of sync. An irregular heartbeat in atrial fibrillation can get up to 200 beats per minute. 

The types of atrial fibrillation include: 

Occasional

This is also known as paroxysmal atrial fibrillation. It’s when your symptoms may last a few minutes or a few hours, but they come and go. You may experience symptoms for as long as a week on rare occasions. 

Persistent

This type of atrial fibrillation keeps your heart rate at an inconsistent pace. You’ll need cardioversion or medications to return your heart rate to normal and maintain that rhythm.

Long-standing persistent 

In this type of atrial fibrillation, your irregular heartbeat is consistently off rhythm, and the symptoms last longer than a year. 

Permanent 

Medication and treatment can’t help your heart return to a normal rhythm in this form of the condition. Permanent atrial fibrillation requires medications to control your heart rate and help prevent clotting.  

Atrial fibrillation with RVR can increase your oxygen demand. It can also lead to tachycardia-induced cardiomyopathies. 

A regular heartbeat rate is 60 to 100 beats per minute. With early detection and the proper treatment, you can still be active and do everyday things.

The difference between atrial flutter and atrial fibrillation

Both atrial flutter and atrial fibrillation are irregular heartbeats. They are arrhythmias of the heart and can cause long-term heart damage if left untreated or unmanaged. 

An atrial flutter happens when the upper chambers of your heart, the atria, go out of rhythm and start pumping rapidly. Atrial flutter is either typical or atypical, depending on where the problem occurs in the pattern of your heart rate. 

Typical atrial flutter

This is specific to your right atrium. This kind of atrial flutter is often short-term and can be cured with an outpatient procedure. 

Atypical atrial flutter 

This is specific to your left atrium. This kind of atrial flutter requires a more lengthy, more involved procedure but can be treated. 

Atrial fibrillation occurs when multiple electrical pulses trigger the atria, causing a rapid ventricular response. This irregular rate usually puts your heart rate in the range of tachycardia symptoms. In most cases, atrial fibrillation occurs in people with an underlying heart condition. 

Risk factors

Some factors that can put you at risk of atrial fibrillation with RVR include:

Having high blood pressure accounts for about 1 in 5 cases of atrial fibrillation. Other risk factors include: 

Diagnosing atrial fibrillation with RVR

Symptoms of atrial fibrillation share similarities to symptoms of other heart conditions. If you experience the following, you should consult with your doctor:

Symptoms can be similar to a heart attack or other serious problems. Understanding the symptoms and realizing the signs can help you know when to talk to your doctor to create an action plan. 

Once you notice symptoms and your doctor suspects atrial fibrillation, they’ll conduct a physical test. They’ll check your heart rate and rhythm. They may also request an electrocardiogram (ECG or EKG) to get a complete diagnosis.

An ECG uses sensors on your chest, arms, and legs to measure electrical currents in your body. This will tell your doctor your heart rate and rhythm, show how your heart’s electrical signals are traveling, and which parts of your heart are causing contractions. You may be requested to wear an ECG for multiple days to monitor your heart over time. 

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Treatment options

Once you’ve been diagnosed with atrial fibrillation, your doctor will assess you for stroke and other risks. They’ll likely first recommend you start taking anticoagulation medication. This will help prevent blood clots and lower your stroke or heart attack risk. 

Your doctor will decide if they should restore normal sinus rhythm or control your ventricular rate. Treatment and management options include: 

  • Medication therapy
  • Electrical cardioversion
  • Catheter-based ablation
  • Surgery

Next, your doctor will ensure your resting heart rate is no higher than 80 beats per minute. If your heart rhythm is still irregular, your doctor will determine if you should go on antiarrhythmic medication or undergo a procedure. 

Your treatment will also depend on how severe your symptoms are and what could be causing the arrhythmia. In less severe cases, you may make lifestyle changes and take medication. You might also need to have a medical procedure to regulate your heartbeat.  

When to see a doctor

Since atrial fibrillation with RVR greatly increases your risk for stroke, you should know the signs of a stroke. Atrial fibrillation increases your risk for ischemic stroke and causes 1 in 7 strokes

Every second counts during a stroke. Treatments work best when a stroke is recognized and diagnosed within 3 hours of your first symptoms. Following the F.A.S.T acronym can help you detect stroke symptoms and get quick treatment to lessen the brain damage caused by the stroke: 

Face. 

Smile and see if one side of your face droops. 

Arms. 

Raise both of your arms and see if one arm lowers on its own. 

Speech. 

Say a simple phrase to someone. Let them tell you if your speech is slurred or incoherent. 

Time. 

As soon as you notice these signs seek immediate medical attention. 

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Medically Reviewed on 3/29/2022
References
SOURCES:

AJMC: "Atrial Fibrillation: Current Management and Best Practices."

CardioSmart: "Update of Atrial Fibrillation Guideline."

CDC: "Atrial Fibrillation," "Stroke Signs and Symptoms."

John Hopkins Medicine: "Atrial Fibrillation," "Atrial Flutter."

Mayo Clinic: "Atrial fibrillation."

MERCK MANUAL: "Atrial Fibrillation."

Shock: "Management of Atrial Fibrillation with Rapid Ventricular Response in the Intensive Care Unit: A Secondary Analysis of Electronic Health Record Data."

UNC Health Talk: "You've Been Diagnosed with Atrial Fibrillation. Now What?"