afib with RVR

rvr being rapid ventricular response.. I reviewed my ablation hospital records and noticed this. Hadn't seen the "RVR" before and of course my heart DR never mentioned it. Reading on the internet it seems as though the atrial sets of the ventricles to basicly afib as well. Is their anything more to it?
Also I noticed in the test section that I had a BN peptide reading that was 313 which is high. Looking into this, I read that taking vit E with 4 tocopherols and 4 tocotrienols can help lower this hormone released by the ventricals. In other readings, it says the opposite. That taking vitamin E is more harmful. Does anyone have any experience with vitamin E?

"Rapid ventricular rate" really just means anything over 100. Maybe 150. At those rates, there is long term risk of heart failure.

1:1 conduction in AF would require a secondary pathway around the AV node, which can exist but is congenital. You don't "get" it with age or time.

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wolfpack

1:1 conduction in AF would require a secondary pathway around the AV node, which can exist but is congenital. You don't "get" it with age or time.

Interesting. So maybe after 10 years on Flecainide I can stop worrying about 1:1 flutter (on the basis that if it was going to happen it would have by now - I've only taken 60mg diltiazem as a preventative this last 3 years) ??



Edited 1 time(s). Last edit at 05/17/2018 02:50PM by mwcf.

Flutter, being a more organized arrhythmia, can couple 1:1 even in folks without accessory pathways. It's rare, but it can happen. I think Shannon and Carey have both experienced it. Thankfully, I have not.

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wolfpack
"Rapid ventricular rate" really just means anything over 100. Maybe 150. At those rates, there is long term risk of heart failure.

1:1 conduction in AF would require a secondary pathway around the AV node, which can exist but is congenital. You don't "get" it with age or time.

Thanks for that info. My usual afib doesn't run that high. Usually in the 80's and 90's. While I was in the hospital it did occasionally run up pretty high. One time they gave me soup that apparently had msg in it and my HR went up to 185 almost immediately..lol.. I should have known better.

When I have a-fib episodes, I always have an extremely rapid heart rate....often between 200 and 250 BPM. I would have to go to the emergency room. After trying several medicines that did not work well....2 cardioversions that did not last long...and 3 ablations, I have been fortunate to be in normal sinus rhythm for more than 3 1/2 years now. I still take Eliquis as a safeguard should the a-fib return. I recently suffered the "broken heart" syndrome during the last days of my son's fatal illness. At that time I had a heart cath to see if there were any obstructions and my heart checked out in good condition with clear arteries. So I suppose that going to the emergency room with the rapid heart rate and getting it under control has helped to keep my heart healthier than it would be if I had not gotten early treatment each time.

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mwcf
Interesting. So maybe after 10 years on Flecainide I can stop worrying about 1:1 flutter (on the basis that if it was going to happen it would have by now - I've only taken 60mg diltiazem as a preventative this last 3 years) ??

I wouldn't recommend it. With prolonged use flecainide can do one of two things: It can simply stop working or it can turn pro-arrhythmic. If it does the latter, 1:1 conduction could be the result. I've known a couple people that happened to, and as wolfpack mentioned, I've been there myself (many times, actually). Trust me, you don't want to experience it. Depending on the actual rate, it could even evolve into v-tach, which is potentially fatal.

Thanks for the responses wolfpack and Carey.

I'll stick with the 60mg Diltiazem with the Flecainide 100mg morning dose as per the last few years. I'd add an evening 60mg Diltiazem but my HR drops into the high 40s from late evening through the night as it is which in and of itself isn't helpful for vagally mediated nocturnal AF. That said, 1:1 flutter does not sound like fun so maybe I'd best add the evening 60mg Diltiazem... what do you guys think? I appreciate most folks would go maybe 1.25mg Bisoprolol am and pm with the 100mg BID Flecainide but again I'm avoiding that given that my AF episodes almost always happen between 1 and 5 am and, as such, are clearly vagal.

What does seem to be happening this last few years is very easy breakthrough of AF with ingestion of MSG (I now have to REALLY watch out for MSG in all tis forms whereas up until 5 years or so ago I didn't) OR the Flecainide starting to lose its efficacy - or a combination of the two.

Ablation at Bordeaux on the cards sooner than later I think. In the meantime I'll just keep trying harder with diet and lifestyle, but once paroxysmal AF shows up more than say 4 or 5 times per year then that'll be bags packed time.

As always, check with your doctor regarding prescription med changes. I wouldn't make any changes unless I felt there was a need, like I was having more breakthrough episodes or otherwise not feeling well.