rapid ventricular response
Summary
A fast, irregular ventricular rate during atrial fibrillation, typically >100 bpm, resulting from rapid AV nodal conduction. Leads to hemodynamic compromise and requires urgent rate or rhythm control.
Detail
Rapid ventricular response (RVR) is the clinical manifestation of uncontrolled atrial fibrillation with AV nodal conduction occurring at rates often exceeding 130 bpm. The chaotic atrial electrical activity generates impulses at 300-400/min, and the AV node normally filters these to allow only 60-100 through. In RVR, enhanced AV nodal conduction permits more rapid ventricular depolarization, impairing diastolic filling, reducing stroke volume and cardiac output. Acute management in hemodynamically unstable patients includes synchronized cardioversion. Stable patients are managed with AV nodal blocking agents: beta-blockers or non-dihydropyridine calcium channel blockers for rate control.
Sources
- First Aid for the USMLE Step 1
- Pathoma
- Harrison's Principles of Internal Medicine
Reviewed by AnkiBoss editorial — medical student review. Information here is for study reference only and is not medical advice. Spotted an error? Let us know.