Atrial Fibrillation with Rapid Ventricular Response (RVR)

Atrium is quivering or fibrillating. Rhythm is irregularly irregular with no discernable P waves. It can be acute or chronic. If Ventricular rate is less than 100 beats per minute then it is call Controlled or Slow Ventricular Response (SVR). If ventricular rate is over 100 beats per minute, then it is call Uncontrolled or Rapid Ventricular Response (RVR).

CAUSES:
Alcohol abuse, Congested Heart Failure, Acute Myocardial Infarction, Hypertension, Hypertrophy, Sick SA node, Pericarditis, Valvular Disease, Hyperthyroidism

INTERVENTIONS:
If Stable: Anticoagulation, Calcium Channel Blockers, Beta Blockers, Inotropics.
If Unstable with Rapid Ventricular Response (RVR): Synchronized cardioversion: Biphasic 120-200 J
If Unstable with Slow Ventricular Response (SVR: correct possible cause (i.e. Digoxin Toxicity) and follow AHA 2016 ACLS Bradycardia algorithm.

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