What Causes Atrial Fibrillation with RVR?

Atrial fibrillation with RVR is a hereditary disease that can be passed from parents to the children. That may indicate that even though adults are healthy and practicing a healthy lifestyle, Atrial fibrillation with RVR can occur in normal hearts due to heredity. Several cardiac causes of Atrial fibrillation with RVR include congested heart failure, acute myocardial infarction – commonly referred to as heart attack, hypertrophy – where muscles of the heart are thickened without obvious or apparent cause, high blood pressure, sick sinoatrial node (the sinoartial node is the generator of the normal sinus rhythm and is located in the hearts right atrium). Coronary artery disease (CAD) also known as atherosclerotic heart disease is another cause for Atrial fibrillation with RVR, whereby degenerative accumulations of lipid containing plaques form on the inmost layer of the coronary artery and block the supply of oxygen and nutrients to the myocardium – heart muscle. Mitral Stenosis is another cardiac condition that can cause the disease Atrial fibrillation with RVR.  This valvular heart disease causes the narrowing of the mitral valve, which is dual flap valve that lies between the left ventricle and left atrium. This valve works by relieving the pressure from the left atrium as it fills with blood by and emptying the blood into the left ventricle during diastole.

When this valve narrows, there is inadequate emptying of the left atrium into the left ventricle leading to fibrillations. Another cardiac condition that can lead to Atrial fibrillation with RVR is Mitral insufficiency also known as mitral regurgitation (MR), a disorder where the mitral valve does not close properly when blood is pushed out of the left atrium.

This causes a back flow of blood to the atrium when the left ventricle contracts, (regurgitation) the phenomena by which the disease gets its name. Hypertrophic cardiomyopathy (HCM) is a disease of the heart muscle that also results in Atrial fibrillation with RVR where the heart walls are thickened without good cause.  The contractile elements that form the heart muscle increase in size, resulting in the misalignment of muscle cells, a situation termed asmyocardial disarray. This misalignment leads to disruptions of electrical impulses in the heart muscles and evidently Atrial fibrillation with RVR.  Another cause for this disease may be pericarditis – an inflammation of the pericardium, the conical sac made of fibrous tissue that surrounds the heart and roots of the blood vessels, valvular diseases, which are any disease processes involving one or more valves of the heart and hyperthyroidism, a condition also referred to as an ‘overactive thyroid’ where the thyroid excretes excess thyroid hormones or thyroxin.

Lung diseases - such as pneumonia, pulmonary embolism- a blockage of the main artery in the lungs and sarcoidiosis- where abnormal growths or nodules appear in the lungs and other organs also cause this disease among a portion of the patients.

The abuse of alcohol is among one of the major lifestyle causes for Atrial fibrillation with RVR.  Results from a study on binge drinking and its effects on the heart revealed that women who consumed at least two drinks per day had a 60percent chance of developing Atrial fibrillation with RVR.  

See the below video to get better idea on the causes: 

What is Atrial fibrillation with RVR?

Definition

Atrial fibrillation with RVR (Rapid Ventricular Response) is a heart condition caused by irregular electrical activity that results in irregular contractions of the heart walls and its chambers. The heart (atrium), shakes with a rapid tremulous movement or makes fine irregular twitching movements, generally referred to as fibrillating.

Further explanation of the condition:

Atrial fibrillation refers generally to cases of irregular heartbeat, may be acute or chronic and can be categorized based on ventricular rate. If the ventricular rate (heart chamber vibrations) is below 100 beats per minute, the condition is termed as Atrial Fibrillation with controlled or Slow Ventricular Response (SVR).If the Ventricular rate is over 100 beats per minute, then it is referred to as Uncontrolled or Rapid Ventricular Response (RVR). Simply described, Atrial fibrillation with RVR is a condition the heart is expanding and contracting too quickly too quickly to refill properly. The condition is found exclusively among adults and is extremely rare in children.

Working of the heart:

To easily identify atrial fibrillation with RVR, it is vital to understand the working of the heart. The atrium or atria (plural) is the upper chamber of the heart, bigger in size compared to the lower chambers known as the ventricles. The atria function by gathering blood as it flows into the heart and shrinking to forward the blood into the ventricles. At the very moment, the smaller ventricle must shrink to forward the blood to all parts of the body. This rhythm of blood flow creates a heart signature voice referred to as the Sinus rhythm. It is important that the sinus rhythm is synchronized so that the atrium does not send blood into the ventricle out of cue. To achieve this, an electric signal is generated to ensure the atrium contracts. When this signal short circuits (bypasses) the atrium, atrial fibrillation with RVR occurs, and the atrium is seen to vibrate just like jelly on a flat surface.

Indication:

A major indication of atrial fibrillation with RVR is a very rapid heartbeat rate, although some patients are known to have the condition without showing symptoms. Atrial fibrillation with RVR may occur when cardiac muscle cells overcome their intrinsic pacemaker’s signals and fire rapidly differently from their normal pattern spreading the abnormal activity to the ventricles. The rapid heart rate can strain the heart, developing a situation referred to as Tachycardia. Atrial fibrillation with RVR can be detected from the various symptoms though it is important to remember that some patients have experienced the condition without symptoms.

Symptoms:

Some of the symptoms of this disease include heart palpitations (described as unnoticed skipped beats or skipped beats noticed from experienced dizziness or difficulty in breathing), shortness of breath when lying flat (orthopnea), shortness of breath (dyspnea after exertion) sudden onset of short breath during the night (also called paroxysmal nocturnal dyspnea) and gradual swelling of lower extremities. As a result of inadequate blood flow, some patients complain of light headedness and may feel like they are about to faint, a condition referred to as presyncope and may actually lose consciousness (syncope). Some patients experience respiratory distress that results in them appearing blue. A close examination of jugular veins usually reveals elevated pressure in some patients (jugular venous distention). When some patients are subjected to lung examinations, crackles and rales may be observed pointing to possible lung edema.

Importance of proper diagnosis:

A good diagnosis of the symptoms shown by patients is important to ascertain that the patient is suffering from atrial fibrillation with RVR.  This is because some forms or irregular and rapid heart rates, tachyarrhythmia, are dangerous and must be ruled out as they are life threatening – such as ventricular tachycardia. Some patients are usually placed on continuous cardio respiratory monitoring, but an electrocardiogram ECG is vital for correct diagnosis.

How is it diagnosed?

Normally, for diagnosis, atrial fibrillation should be present, characterized by chaotic electrical activity between the QRS complexes- the name given to the combination of the three of the graphical deflections as seen on a typical electrocardiogram (ECG).

The QRS complexes should be narrow, to signify that they are being initiated by normal conduction of atrial electrical activity through the Intra-ventricular conduction system, or heart conduction system. Wide QRS complexes could point to ventricular tachycardia, although wide complexes may also be an indication of disease processes in the Intra-ventricular conduction system. The R-R internal will also likely be irregular. It is also important to find out if there are triggering causes for the tachycardia which include dehydration, Hypovolemia - a decrease in blood volume, and more specifically decrease in blood plasma volume. You can go ahead to eliminate Acute coronary syndrome – which refers to any diseases that are directly attributed to the obstruction of coronary arteries.