Afib with RVR

Kati2005 said:

At what point do you consider afib to be with RVR? My preceptor told me that if my patient has chronic afib and the rate is over 100 than its afib with RVR. My patient last night has a history of chronic afib. They gave her digoxin and amiodarone last night but her heart rate remained 90s-120s and BP was stable.

Afib with RVR (rapid ventricular response)

- Ventricular rate of greater than 100 bpm (doesn't make a difference if it is a new onset of Afib or Chronic Afib - it's based on the ventricular rate)

Controlled Afib

- Ventricular rate under 100

>100 is RVR ... in addition, beta blockers and/or calcium channel blockers that increase sa node refractory time work to slow VR.

Thanks for your help.

just my 2 cents,.....while the definition of Afib c RVR may be >100,..as I assume you are eluding to in your OP,.many Dr's especially Cardiologists do not treat rates in the 120's and many times all the treatment in the world will only drop some people to 110's.

I transfered from Cardiology step down to ER little over a year ago,..ER treats many pt's that I personally had cared for in the unit,.Cardiologist knows the pt,.they have been in Afib for 20 + years,.sometimes they get tachy (usually when they are a bit dehydrated),. Cardiologists only treated if the pt became SOB or very hypotensive. Many times ER starts a gtt,..get them to the unit and slowly dc it!

RN-Cardiac said:

just my 2 cents,.....while the definition of Afib c RVR may be >100,..as I assume you are eluding to in your OP,.many Dr's especially Cardiologists do not treat rates in the 120's and many times all the treatment in the world will only drop some people to 110's.

I transfered from Cardiology step down to ER little over a year ago,..ER treats many pt's that I personally had cared for in the unit,.Cardiologist knows the pt,.they have been in Afib for 20 + years,.sometimes they get tachy (usually when they are a bit dehydrated),. Cardiologists only treated if the pt became SOB or very hypotensive. Many times ER starts a gtt,..get them to the unit and slowly dc it!

We tend to treat new onset afib with RVR rather aggressively in the ER (Cardizem bolus with subsequent cardizem drip). If the patient has a history of it, and has been ill (like with a stomach bug), we'll give them a liter or two (providing that CHF isn't an issue as well), and see how their cardiologist wants to proceed. Working dayshift, we have the luxury of attending cardiologists aplenty wandering around...:nuke:

Blee