I had my first episode approx 5 years ago. Always sudden onset always with RVR, rapid Ventricular Response 180/200, taken to ed by ambulance, first two in af with rvr for three days reverted chemically. Last two in af with rvr then cardioverted. Never slow af always super fast.Painful and scary, now my nerves are shot. I was on bisoprolol and last two years and three months before another one.
They put me on sotalol but doses where to low or two high after a month I convinced them to put me back on bisoprolol 3 days but I'm nervous and feel like it's not working the same as before.
Please help with experience and advice as I know a lot of people get af but haven't spoken to people who only get af with rvr (really fast heart rate) so I feel very alone and I'm confused about what meds to take.
Thankyou x
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Gypsy9270
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There are plenty of people who have HRs even higher than yours so you are not alone. First thing I would say is have you been assessed for stroke risk as anticoagulation is important, CHADS2VASC2 (google it) is the score system if you care to check it out.
There are drugs to try to stop you going into AF whereas bisoprolol merely limits rate when you are so maybe you need to see an arrhythmia specialist if you have not done so far.
I have been on Xarelto since the first episode five years ago and they recently put me on sotalol but it was keeping my heart rate very low then very high if I got out of bed was hard to cope with all the symptoms. I go into af when my heart rate is higher so I'm a sense that's why I feel safe on bisoprolol.
If anyone has experience with sotalol would be appreciated.
Yes I understand that, I was on chanel blocker for two years then they took me off that and put.me on a beta blocker. They didn't want me on both. Don't know why.
I have afib with RVR, I don't really know what the difference is but I know the doctors and ambulance tried to stabilize me quickly because of the RVR bit, and I don't know if everyone with afib who has a rapid HR has RVR or not because I can't find too much about it but I did find an article from December 9 2023 from dr. Afib if you look it up. I will quote a little if it is allowed on here...
'AFib with RVR is a challenging yet conquerable subtype of atrial fibrillation.
In cases of AFib, rapid ventricular response (RVR) occurs when the atria fibrillates and causes the ventricles to beat too quickly. This results in symptoms like a rapid or fluttering heartbeat.
What is the Difference Between AFib and AFib with RVR?
AFib is an irregular and often rapid heartbeat caused by the atria quivering or fibrillating. AFib with RVR refers to a rapid ventricular rate that occurs when the irregular electrical signals from the atria are transmitted to the ventricles at a faster-than-normal rate, leading to compromised heart function.'
Anyway for me, I was normal, vomited and then my heart went nuts and wouldn't stop. It felt like there was a chicken in my chest trying to get out. I was chemically converted after 44 hours. I think I may have had a couple of afib episodes prior over the course of the past 10 years. I am now 57. Since the last episode in November my heart has been very sensitive and jittery (last night I had some long runs of PVCs bigeminal after being jolted awake from my sleep.) I am scared of it happening again if I am not near a hospital. So I am actually having an ablation on Tuesday as recommended by my EPs times two. The thinking is the earlier you ablate, the less work there is to do and the higher the success rate. It is recommended in cases like mine as a first choice in treatment in the US. I don't take BBs because when stable my heart rate drops too low. So, I don't know how many people with afib have the rvr subtype, is it the majority or not?
So, my afib has not yet occurred as many times as yours but I do know how scary it is which is why i want to kill the afib now....
Thankyou so much for your response, stress triggers mine and they are terrifying. I find I get a lot of pain when I'm in rapid hr with af, it's seems to be more unusual having this type. I get scared as well, my cardiologist said to accept I have it, try to prevent it but when episodes happen understand it's unlikely to kill me being on blood thinners. I have had that when I wake up and my heart's racing or starts it horrible.
They put me back on sotalol today so hoping it works well.
I want an ablation but I'm a public patient so they won't do it yet.
I can't have an ablation, nor conversion, nor anti-arrhymic drugs. Reason the ECHO shows abnormal structure - severe dilated left atrium and Right Ventricle Regurgitation which I thought RVR abbreviation explained.
If meds keep you controlled then there is no reason to ablate.
Carefully balancing the risks - like going from rapid AF to low heart rate isn't fixing the problem as the next step is a PM Pace Maker or Defribrillator preventing the heart from going so low.
I reckon more research, better advancement in understanding our hearts in AF could lead to more natural procedures to stop rogue electrical strikes.
In my opinion. Scarring your heart by freezing or burning sounds pretty awful to me.
Then I have a " very bad rib cage" but because of it my heart has been pushed further left so I don't feel flutters, palpations, pain and yet I was in rapid and persistent AF for 2 years 3 months until I was offered CCB.
But now controlled in BP and Heart Rate.
An ECHO. ECG and 24/48 hr Heart Monitor tell the story of your heart.
I am having a pulse field, so not sure what that does, but it kills the rogue cells. The doctors say here that it is so much easier to ablate early on before the rogue cells get really set in. Obviously the thought of it is scary but I am youngish and exercise a lot so I do not want to have permanent afib. I am glad the meds work for you and sorry that you can't have an ablation but it sounds like you wouldn't consider it anyway. I am just going to have to put all my trust in the doctor!!
Thank you! It is scary but I don't want to be on a long haul flight and suddenly go into Afib with rvr. I will ask the doctor about the rvr bit to see if it the same as those with afib with the rapid heart rate. I do know that my cardiologist told me to go to ER after 30 minutes of it if it happens again, but I don't know how much he knows about afib.
I am lucky in that I can choose from so many Electrophysiologists and I have some of the best near me in Texas. I had an in depth discussion with the NP about possible side effects from the procedure and she really put me at ease, saying the doctor is very good (he is supposedly one of the best in the World, so I am going to fully put my trust in his skills and go ahead with it!)
I do think the risk of a stroke is the main issue with everyone, and being on a thinner alleviates a lot of the worry. I hope the sotalol works for you and you can keep it under control...
That sounds really good, I will pray for you sweetheart, to be honest my last one came so unexpected I hadn’t had one for over two years and was not expecting it. Because my heart does so fast it stresses me and scares me. I joined a private health fund so I’m 12 months I can choose my own doctor. Atm I’m a public patient and the government pays but I don’t get to choose my doctor etc. Stay in touch and let me know how it goes. Xx
I had the ablation and it went well. They say there is a 90% chance it will work. I asked the nurse about afib with rvr and he said it’s when the hr is greater than 120 bpm. Not everyone has a fast hr with afib but it’s fairly common .. I hope you can get on the list to have it done. My doctor is world renowned and has done a great job!
I was diagnosed with AF with RVR. Heart rate always goes to about 190. 120mg diltiazem ER worked well for me. It is a calcium channel blocker, so it controls heart rate.
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Amiodarona- I’ve been on it a week and feel very shaky, almost like tremors inside. Just wondering if I should continue with it ? 
Is there anyone else who doesn't know if their symptoms are a result of drugs or the condition?
Flecainide 
Metoprolol, flecainide and prevention?
Bisoprolol. How long does it keep the AF away for, until returning back as an attack...?
