Does your heart feel like it's beating too fast? Let's learn about A-fib with RVR! (Atrial Fibrillation with RVR)

Have you ever felt like your heart is beating like crazy, or you feel like you have a strange feeling in your chest? Or do you feel like you are having trouble breathing or are dizzy? These may not be just other things. Today we are going to talk about this kind of problem that occurs in the heart, that is, a condition in which the heart beats irregularly and very quickly, called `(Atrial Fibrillation with Rapid Ventricular Rate)` or `(A-fib with RVR)` for short. Don't be afraid, it is very important to be aware of this.

What exactly is A-fib with RVR?

Simply put, `(A-fib with RVR)` is a condition in which your heart's rhythm, or beating pattern, becomes abnormal. We have two upper chambers in our heart, which we call the atria. These `(atria)` are where the electrical signals that tell the heart to beat start. But in someone with `(Atrial Fibrillation)`, these electrical signals are chaotic, out of order, and the upper chambers `(atria)` start contracting very quickly. It's like someone is beating a drum like crazy.

Now these chaotic electrical signals go to the two lower chambers of the heart, the ventricles. Then the beating of those ventricles becomes irregular and very fast . That's what it's called ``A-fib with RVR''. That means the heart beats more than 100 times per minute.

Think of it like a water pump. If it's not working properly, it can't pump the blood it needs to the body. That's what happens when you have `(A-fib with RVR)`. The heart doesn't have enough time to fill with blood properly, so it can't pump enough oxygenated blood to the body.

How common is this condition?

You might think that this is a disease that affects very few people. But in fact, ``Atrial Fibrillation`` is the most common condition among heart rhythm abnormalities. If you look at the statistics in a country like America, millions of people suffer from this condition. This condition is also increasingly seen in Sri Lanka.

What are the symptoms of this? How to recognize it?

Not everyone experiences the same symptoms. Some people may have the condition without any symptoms. However, there are some common symptoms:

• Heart palpitations : It can feel like your heart is pounding or pounding inside your chest.
• Dizziness : It can feel like your head is spinning, sometimes to the point of being unable to stand.
• Passing out: Some people may lose consciousness and fall if this condition is severe.
• Chest pain : There may be a pain that feels like the chest is constricting or pressing.
• Shortness of breath : Not only when you are slightly tired, but even when you are just standing still, you may feel short of breath.
• Frequent anxiety : You may feel fear and anxiety for no reason.
• Fatigue : No matter how much sleep you get, you may still feel tired and lifeless.

These symptoms can be very mild at times, and very severe at other times. So if you experience anything like this, it's best to see a doctor .

Why is this happening? What are the reasons?

There are several factors that can cause `A-fib with RVR`. The main ones are:

• Coronary artery disease : This means blockage of the arteries that supply blood to the heart.
• High blood pressure : We all know the term "high blood pressure".
• Heart failure : The heart is unable to pump enough blood to the body.
• Obstructive sleep apnea: Stopping breathing during sleep while snoring.
• Heart surgery : This risk may persist for several days or weeks after some heart surgeries.

Who is most at risk for this?

Some people are more likely to develop this condition. See if you fall into this category:

• People over 50 years of age : This risk increases with age.
• People with a body mass index (BMI) of over 30 : This means that they are significantly overweight for their height.
• People with obstructive sleep apnea.
• People who drink a lot of alcohol : The risk is higher if you drink a lot of alcohol daily or frequently.
• People who consume too much caffeine : It's also not good to drink too much coffee or tea during the day.
• If someone in your family has had `(A-fib)` : There may also be a genetic influence.

Remember: Having one or more of these risk factors does not mean you will definitely develop ``A-fib with RVR''. However, it is important to be aware of these.

What complications can this cause?

If `A-fib with RVR` is not treated properly, some dangerous complications can occur.

• Decreased time for the lower chambers of the heart to fill with blood.
• The heart muscle needs more oxygen .
• Cardiomyopathy : A condition in which the heart muscle becomes weak and enlarged.
• Stroke : A stroke can occur if a blood clot forms in the heart and travels to the brain, blocking an artery. This is the most dangerous complication .
• Low blood pressure .
• Congestive heart failure .

That is why it is important to be aware of this condition and seek treatment quickly.

How is this diagnosed? What tests are done?

If you have the symptoms mentioned above, when you see a doctor, he will examine you, ask about your medical history, and then order several tests to confirm the condition.

The most common tests are:

• Electrocardiogram (ECG or EKG) : This records the electrical activity of the heart. It can clearly identify if there is `(A-fib with RVR)`.
• Echocardiogram : This is like an ultrasound scan of the heart. It can check whether the heart's chambers and valves are working properly, and how big the heart is.
• Cardiac CT scan or MRI scan : These can provide more detailed information about the structure of the heart.
• Blood tests : These help detect things like thyroid problems and changes in electrolytes in the blood.

What is the treatment for this?

The good news is that there are effective treatments for A-fib with RVR. Your doctor has two main goals: to control your symptoms, and to prevent the complications mentioned above from occurring.

The following are mainly used as treatments:

• Balancing Electrolytes : Since an increase or decrease in electrolytes such as potassium and magnesium in the body can affect the heart rhythm, treatment is used to maintain them properly.
• Medicines : The main treatment for this is medication.

What medications/treatments are used?

There are several types of medications given for `A-fib with RVR`:

• Beta-blockers : For example, metoprolol (Lopressor® or Toprol®XL). These work by slightly slowing the heart rate and reducing the pressure on the heart.
• Calcium channel blockers : For example, diltiazem (Diltzac® or Cardizem®). This type of medication also slows the heart rate by controlling the entry of calcium into the heart muscle cells.
• Antiarrhythmics : For example, amiodarone (Pacerone® or Cordarone®) or digoxin (Lanoxin® or Cardoxin®). These help to restore the heart's irregular rhythm.

The most important thing! When you have `(A-fib)`, there is a high chance of blood clots forming inside the heart. If these blood clots travel to the brain, a `(Stroke)` can occur. Therefore, anticoagulants , or what we call "blood thinners", are almost always prescribed.

For some people who cannot continue taking these blood-thinning medications, a special procedure called left atrial appendage closure may be performed to prevent blood clots from forming.

Sometimes it is difficult to control this condition with medication alone. In such cases, other treatment methods may be needed:

• Catheter ablation : This involves finding the areas of the heart where the erratic electrical signals are coming from, and passing a small catheter (thin tube) through the leg or arm into the heart, 'disabling' the areas where the erratic signals are coming from. Then the erratic signals stop coming.
• Pacemaker : Some people have a small device implanted under the skin to control their heart rate. This is called a pacemaker. It sends electrical signals to the heart, especially when the heart rate is slow.
• Electrical cardioversion : This involves administering a brief anesthetic and delivering an externally controlled electrical shock to the heart, which instantly restores the heart's rhythm.
• Maze procedure : This is a slightly more complicated procedure. Small incisions are made in the atria of the heart to create the correct pathways for electrical signals to travel. This is usually done during another heart surgery.

Are there any side effects of the treatment?

As with any medical treatment, some side effects or complications can occur with this `(A-fib with RVR)` treatment. However, they do not happen to everyone, and they are usually minor.

• From medications : Some people may experience things like headaches, low blood pressure, dizziness, and stomach upset.
• Procedures such as catheter ablation can cause cardiac tamponade or, very rarely, a heart attack.
• Pacemakers can sometimes not work properly.
• Heart palpitations or ``A-fib'' may recur for several months after the Maze procedure .

Your doctor will inform you about this. There is no need to worry, because doctors always try to minimize these risks.

How soon will I feel better after treatment?

This really depends on the treatment you are receiving. Some medications, such as intravenous (IV) medications, can help slow your heart rate and start to feel better within minutes . Other treatments may take longer to work. The most important thing is to follow your doctor's instructions exactly.

How can I reduce this risk?

There are several things you can do to reduce your risk of developing `(A-fib with RVR)`. These are not only good for the condition, but also for your overall health:

• Exercise at a moderate pace for at least 150 minutes a week : walking, cycling, or swimming are good.
• Eat heart-healthy foods : Include vegetables, fruits, legumes, whole grains, and fish in your diet. Reduce oil, salt, and sugar.
• Limit alcohol consumption : It is best to reduce it as much as possible.
• Avoid tobacco products completely : If you smoke, quit.
• If you have other medical conditions such as high blood pressure, high cholesterol, sleep apnea, or diabetes, control them well.

If I have `(A-fib with RVR)`, what should I expect?

Finding out that you have `(A-fib with RVR)` can be a bit of a shock. But remember, this is a condition that can be managed and you can live a good life . The important thing is to establish the healthy habits mentioned earlier, take the medications your doctor prescribes exactly, and seek specialized treatment if necessary.

If left untreated, it can lead to serious conditions such as heart disease, heart failure, or stroke. Treatments such as catheter ablation have been shown to be successful in many people. The Maze procedure has an 80% to 90% success rate, and can provide long-term relief from symptoms.

How long will this situation last?

``(A-fib with RVR)`` is a condition that can sometimes last for years. For some people, the frequency and duration of this condition can increase over time. That's why it's important to continue to follow your doctor's advice and get regular checkups.

How do I take care of myself?

Your health is in your hands. Remember this:

• Take all medications prescribed by your doctor exactly and on time. Don't miss a single day.
• See your doctor on scheduled follow-up appointments. It's very important to see how you're doing.
• Exercise regularly. Even something as simple as a daily walk can improve your quality of life and help you perform daily tasks more easily.

When should I see a doctor?

If you experience any of these symptoms again, or if you experience new ones, see a doctor immediately:

• Chest pain.
• If your heart rate is more than 100 beats per minute when you are at rest.
• Dizziness.
• Difficulty breathing.

When should I go to an Emergency Treatment Unit (ETU) ?

If you have these symptoms, you should go to an Emergency Treatment Unit (ETU) without delay :

• Symptoms of a stroke : Sudden severe headache, blurred vision, difficulty speaking, difficulty walking, and drooping of one side of the face.
• Excessive bleeding due to blood thinners : vomiting red blood, passing red or black stools, passing red urine.
• Chest pain or other symptoms of a heart attack or cardiac arrest : Severe shortness of breath, severe stomach discomfort, and sweating.

What questions should I ask my doctor?

When you visit your doctor, you can ask these questions to get a clear understanding of your condition:

• How often do I have to see the doctor (follow-up)?
• How long does it take to see results from lifestyle changes?
• What medicine do you recommend for me? What is the reason for that?
• Should I undergo treatment such as cardioversion, ablation, or maze procedure?

Feeling an irregular heartbeat can be distressing. However, there are effective treatments for this condition called ``A-fib with RVR''. Your doctor can help you choose the treatment that is right for you. By seeing your doctor on time and taking your prescribed medication exactly as prescribed, you can help protect your health.

Take-Home Message: The most important things to remember

Okay, so let's summarize some of the things you need to remember from what we've talked about:

• ``(A-fib with RVR)`` is a condition in which the heart's rhythm is irregular and beats very fast.
• If you experience symptoms such as chest tightness, dizziness, or difficulty breathing , be sure to seek medical advice.
• This can be caused by a number of factors, including high blood pressure and heart disease.
• Stroke is one of the most dangerous complications of this, so it is very important to take blood-thinning medication.
• There are various treatment methods, such as medications and catheter ablation.
• Healthy lifestyle changes (eating well, exercising, and quitting smoking) go a long way in controlling this condition.
• Take the medication exactly as prescribed by the doctor. Follow-up with the doctor on the scheduled dates.
• If you experience emergency warning signs (stroke symptoms, heavy bleeding, severe chest pain) , go to the hospital immediately.

You are not alone. There are many people living with this condition. With the right treatment and lifestyle, you too can live a healthy life. Don't be afraid to talk to your doctors and solve your problems.

` Heart palpitations, heart disease, A-fib, RVR, rapid heartbeat, chest pain, stroke