AFib With Rapid Ventricular Response (RVR)

Medically Reviewed by Nayana Ambardekar, MD on August 07, 2022
3 min read

Atrial fibrillation with rapid ventricular response is a fancy name for an irregular heartbeat.

When your heart's electrical signals aren't working right, it can lead to a heartbeat that's too fast. This abnormal heart rhythm is what doctors call atrial fibrillation, or AFib for short. For most people, the faulty signals start in the heart's two upper chambers, called the atria.

During atrial fibrillation, the heart's two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart.

Sometimes the misfiring signals can also make your heart’s two bottom chambers, called ventricles, beat too quickly. That’s a specific type of atrial fibrillation called AFib with rapid ventricular response.

You might feel:

Electrical signals make your heart beat in a coordinated way. First, the atria squeeze, or contract. Then the signal travels to the lower chambers, or ventricles. They squeeze and pump out blood to your lungs and body.

In AFib, these signals don't go out correctly. Instead of contracting, the atria quiver. The flutters are too weak to send enough blood into the ventricles. In AFib with rapid ventricular response, the ventricles also beat too fast. These beats are too weak to push enough blood out of the heart to your lungs and body.

A normal heartbeat is 60 to 100 beats per minute (BPM). In AFib with RVR, your heart rate can reach more than 100 BPM.

You're more likely to get atrial fibrillation if you have:

Any type of AFib can lead to a stroke or heart failure. If you don't get treated, over time the condition can damage your heart muscle and lead to heart failure.

But the right treatment will bring your symptoms under control and get you back into a healthy rhythm.

Short-term treatment depends on your overall condition. If you aren’t stable, you’ll probably get:

  • Drugs called beta-blockers. They control your heart rate. Your doctor will get them to you in your vein (they’ll call this intravenously) if you have AFib with RVR. The most commonly used drugs are:

Your doctor’s goal is to get you stable enough for:

  • Electrical cardioversion: Your doctor gives your heart a shock to reset your heartbeat. They’ll use paddles or stick patches called electrodes onto your chest.
    • First, you'll get medicine to make you fall asleep. Then, your doctor will put the paddles on your chest, and sometimes your back. These will give you a mild electrical shock to get your heart's rhythm back to normal.
    • Most people only need one. Because you’re sedated, you probably won’t remember being shocked. You can usually go home the same day.
    • Your skin may be irritated where the paddles touched it. Your doctor can recommend a lotion to ease pain or itching.

If you’re more stable, you’ll just get heart rate medications and you and the doctor can decide if you need cardioversion later.

Once your heart rate is under control, they may suggest long-term treatment with a wider choice of beta-blockers:

Or they might have you try one of the calcium channel blockers -- diltiazem or verapamil.