A-fib with RVR refers to atrial fibrillation with a rapid heart rate, or rapid ventricular response. RVR is a complication of A-fib that disrupts blood supply to the body and can involve chest pain, palpitations, and other symptoms.

People with atrial fibrillation (A-fib) with rapid ventricular response (RVR) or other irregular heart rhythms should seek medical attention. Some people may need to spend time in the hospital.

Atrial fibrillation can come and go or become persistent. There is often an association between A-fib and rapid heart rates. Medication can help manage rapid heart rates in atrial fibrillation or help keep the heart in a normal rhythm

In this article, find out what A-fib with RVR involves, how to recognize it, and what to do if it happens.

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A-fib is the most common rhythm disorder of the heart. In the United States, it affects over 2.7 million people, according to the American Heart Association.

In a healthy heart, the heart’s chambers beat regularly and rhythmically.

A-fib results from faulty electrical signals in the upper chambers of the heart. In people with A-fib, the upper chambers beat quickly and erratically, out of sync with the lower chambers. In A-fib with RVR, the lower chambers beat too quickly and irregularly, resulting in a rapid heart rate.

RVR can develop in people with A-fib, disrupting the regular supply of blood to the body’s organs.

A doctor may diagnose an RVR from a rapid and irregular ventricular rate when a person’s heart rate is greater than 100 beats per minute (bpm). However, some researchers use 110 bpm as the upper limit. For people with A-fib, the target is usually below this level.

Sometimes, RVR happens for no specific reason, but factors that may trigger it include:

What triggers an A-fib attack?

An A-fib with RVR may produce no symptoms. It may only emerge during a physical examination or a heart rhythm test.

A person with A-fib may experience some or all of the following symptoms, and RVR can make the symptoms worse:

A-fib may come and go or persist, with or without RVR.

A doctor may describe it as:

  • Paroxysmal: Paroxysmal A-fib lasts up to 7 days.
  • Persistent: Persistent A-fib lasts more than 7 days
  • Long-standing persistent: Lasting longer than 1 year, despite treatment.
  • Permanent: The A-fib persists despite attempts to restore the usual heart rhythm.

What are the different types of A-fib?


A-fib with RVR can lead to serious complications, such as:

Is it safe to exercise with A-fib?

A doctor may perform several tests to diagnose A-fib with RVR, including:

  • Electrocardiogram (ECG): In an ECG, small electrodes attached to the chest and arms record the electrical signals passing through the heart.
  • Rhythm monitor: A monitor, such as a Holter monitor, is a wearable ECG device that records the heart continuously.
  • Event recorder: This is a type of Holter monitor worn for up to 1 month. When cardiac symptoms occur, they activate the monitor.
  • Chest X-ray: An X-ray can help evaluate other heart or lung conditions that may cause similar symptoms.
  • Echocardiogram: In an echocardiogram, also known as an echo, sound waves create pictures of the heart that allow doctors to see blood clots that may result from A-fib.
  • Blood tests: Blood tests can rule out conditions with similar symptoms, such as thyroid disorders.

How do doctors diagnose A-fib?

Possible treatments for A-fib with RVR include:

  • medications
  • procedures to reset the heart’s rhythm
  • invasive procedures, such as catheter ablation
  • preventive measures

Treatment approaches can include a rate control approach or a rhythm control approach.

A rate control approach aims to manage the heart rate, although the person may either stay in A-fib or go in and out of A-fib.

In rhythm control, doctors use medications or procedures to try to keep the heart in a normal rhythm.

Does Medicare cover A-fib?


Options for medicinal management for A-fib with RVR include:

Which medications can treat A-fib?


In the hospital, a doctor may use a technique known as cardioversion.

In electrical cardioversion, a doctor will deliver a brief electrical shock to momentarily stop the heart, which shocks it into resetting to a normal rhythm.

In chemical or pharmacological cardioversion, a person takes antiarrhythmic drugs by mouth or intravenously. This usually happens in a hospital, although a doctor may prescribe pills for a person to use when they notice signs of A-fib. The drugs regulate the heart’s rhythm.

Invasive procedures

A doctor may recommend invasive procedures for A-fib with RVR if other options are not effective.

Options include:

Pulmonary vein ablation

Catheter ablation is when a doctor inserts a long tube through the groin to access the blood vessels in the heart.

In pulmonary vein ablation, when the catheter reaches the heart, the tip will either freeze or heat areas of the heart that are misfiring to kill the tissue and restore the heart’s regular rhythm.

If the surgery is successful, it cures the arrhythmia without the need for further medication to manage the heart’s rate or rhythm.

Atrioventricular (AV) node ablation

As with pulmonary vein ablation, a doctor inserts a catheter into an artery in the groin and threads it through the artery to the heart.

When the catheter reaches the upper chambers of the heart, radiofrequency energy destroys the small area of tissue that connects the upper and lower chambers.

The doctor will implant a pacemaker and the person will continue using blood thinners.

The person will need a pacemaker because the procedure has cut off communication between the upper and lower chambers. This can lead to a slow rhythm, known as bradycardia. The pacemaker will help the heart continue beating at a steady rate.

Surgical maze procedure

The maze procedure involves open heart surgery. It creates scar tissue in specific areas of the heart to stop electrical impulses from misfiring.

This procedure has a high success rate, but A-fib may recur. The surgical maze procedure is usually only for people having cardiac surgery for other reasons, such as a valve replacement.

What to expect with A-fib surgery.

A-fib with RVR is treatable, but doctors consider A-fib a chronic, or long-term, disease. People may need to continue with medications and other treatments to manage their symptoms and reduce their risk of stroke or heart failure.

A doctor may also recommend some lifestyle tips, such as:

These tips can also help prevent heart problems from developing.

Anyone with A-fib should follow a doctor’s advice and take all medications as directed.

Are there any natural remedies for A-fib?

Atrial fibrillation with rapid ventricular response is a type of irregular heart rhythm. A-fib can lead to RVR, and RVR can increase the risk of complications, such as blood clots or stroke.

Treatment for both will be the same and includes medications, invasive procedures, and lifestyle choices. Treatment will aim to manage the heart rhythm and prevent further problems.

There may be no symptoms of A-fib or A-fib with RVR, but attending regular checkups can help a doctor diagnose problems early when they are often easier to treat.

What is the best diet for A-fib?